Recurrent central nervous system blastomycosis in an immunocompetent child treated successfully with sequential liposomal amphotericin B and voriconazole.
Central nervous system involvement in infection with Blastomyces dermatitidis is uncommon, except in immunocompromised patients. We report a case of central nervous system blastomycosis occurring 18 months after treatment of pulmonary blastomycosis in an immunocompetent child. Our patient was successfully treated sequentially with liposomal amphotericin B followed by oral voriconazole without need for surgical resection.
Division of Pediatric Hematology/Oncology, Children's National Medical Center, Washington, DC, USA.
Jyoti
J
Panicker
Thomas
T
Walsh
Naynesh
N
Kamani
D000293:Adolescent; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001758:Blastomyces; D001759:Blastomycosis / Q000188:drug therapy* / Q000382:microbiology; D020314:Central Nervous System Fungal Infections / Q000188:drug therapy* / Q000382:microbiology; D004334:Drug Administration Schedule; D006801:Humans; D007121:Immunocompetence; D008297:Male; D011743:Pyrimidines / Q000008:administration & dosage / Q000627:therapeutic use*; D012008:Recurrence; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; C068538:liposomal amphotericin B; D000666:Amphotericin B; D065819:Voriconazole