Successful treatment of multiple Pseudallescheria boydii brain abscesses and ventriculitis/ependymitis in a 2-year-old child after a near-drowning episode.
BACKGROUND
We report on a cerebral infection by Pseudallescheria boydii in a 21-month-old boy after a near-drowning episode. MRI revealed multiple (> 60) intracerebral abscesses.


METHODS
The surgical therapy included CSF drainage and microsurgical resection of one abscess for microbiological diagnosis. Antimycotic therapy included terbinafine and intraventricular caspofungin in addition to voriconazole.


RESULTS
Systemic side effects of chemotherapy were not observed. After placement of a ventriculoperitoneal shunt, the boy was transferred to a rehabilitation clinic and improved neurologically. After 20 months, MRI documented a continuing remission of the disease.


CONCLUSIONS
Our case proves that an aggressive treatment should be undertaken and can be successful in CNS pseudallescheriasis.
Mursch
Kay
K
Department of Neurosurgery, Zentralklinik, Robert-Koch Allee 9, 99438, Bad Berka, Germany.
Trnovec
Svorad
S
Ratz
Heinrich
H
Hammer
Detlef
D
Horré
Regine
R
Klinghammer
Albrecht
A
de Hoog
Sybren
S
Behnke-Mursch
Julianne
J
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000150:complications / Q000382:microbiology / Q000628:therapy*; D004679:Encephalomyelitis / Q000150:complications* / Q000628:therapy*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008271:Mycetoma / Q000209:etiology*; D015701:Near Drowning; D009493:Neurosurgery / Q000379:methods; D011541:Pseudallescheria
D000900:Anti-Bacterial Agents