Successful treatment of aspergillus brain abscess in a child with acute lymphoblastic leukemia and liver failure.
Invasive fungal infection continues to pose a significant threat to immunocompromised patients, with cerebral aspergillosis being among the most feared ones. The authors describe an adolescent girl with acute lymphoblastic leukemia (ALL) with subsequent acute liver failure, who developed an aspergillus brain abscess. The patient was treated with combined antifungal therapy using amphotericin B local instillation, prolonged systemic amphotericin B colloidal dispersion along with vinca alkaloids-containing chemotherapy, followed by neurosurgical débridement and oral voriconazole in the setting of ongoing antileukemic maintenance chemotherapy. Her ALL remains now in complete remission 30 months from diagnosis, with no evidence of fungal infection.
Sterba
Jaroslav
J
Department of Pediatric Oncology, Children's University Hospital Brno and Masaryk University, Cernopolni Str. 9, 625 00 Brno, Czech Republic. jsterb@fnbrno.cz
Prochazka
Jaroslav
J
Ventruba
Jiri
J
Kren
Leos
L
Valik
Dalibor
D
Burgetova
Dagmar
D
Mudry
Peter
P
Skotakova
Jarmila
J
Blatny
Jan
J
D000293:Adolescent; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001228:Aspergillosis / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D001922:Brain Abscess / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011743:Pyrimidines / Q000008:administration & dosage; D012074:Remission Induction; D014230:Triazoles / Q000008:administration & dosage; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D000666:Amphotericin B; D065819:Voriconazole