Chronic granulomatous disease presenting with disseminated intracranial aspergillosis.
We describe an 8-year-old boy who presented with multiple unresectable aspergillus brain abscesses as the initial presentation of X-linked chronic granulomatous disease (CGD). He failed initial therapy with amphotericin B, but was subsequently salvaged with voriconazole. CGD should be considered in the differential diagnosis for all children presenting with invasive fungal infections, particularly, those involving the central nervous system (CNS). Whereas, optimal pharmacologic therapy is still unknown for CNS aspergillosis, voriconazole may have an advantage due to its ability to cross the blood brain barrier and excellent oral absorption and bioavailability.
Alsultan
Abdul
A
Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA. Frederick-goldman@uiowa.edu
Williams
Marc S
MS
Lubner
Sam
S
Goldman
Frederick D
FD
D000935:Antifungal Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology / Q000473:pathology; D020314:Central Nervous System Fungal Infections / Q000175:diagnosis; D002648:Child; D003937:Diagnosis, Differential; D006105:Granulomatous Disease, Chronic / Q000150:complications* / Q000473:pathology; D006801:Humans; D016867:Immunocompromised Host; D008279:Magnetic Resonance Imaging; D008297:Male; D020953:Neuroaspergillosis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D011743:Pyrimidines / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole