title: Chronic granulomatous disease presenting with disseminated intracranial aspergillosis.
abstract: 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.
authors.affiliation: Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA. Frederick-goldman@uiowa.edu
authors.forename: Abdul
authors.initials: A
authors.lastname: Alsultan
authors.forename: Marc S
authors.initials: MS
authors.lastname: Williams
authors.forename: Sam
authors.initials: S
authors.lastname: Lubner
authors.forename: Frederick D
authors.initials: FD
authors.lastname: Goldman
mesh_terms: 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
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole