title: CNS-manifestation of aspergillosis in an extremely low-birth-weight infant.
abstract: Invasive aspergillosis is a rare condition in term and preterm infants. We present here the fatal case of a 28-week gestational age preterm baby who developed pulmonary, hepatic and central nervous system aspergillosis during the first days of life. A hyperechogenic lesion adjacent to the lateral ventricle was diagnosed by ultrasound and initially considered to represent periventricular leukomalacia. Within several days the lesion increased in size and was then falsely considered to be an intraventricular haemorrhage. Aspergillus fumigatus was ultimately isolated in the tracheal aspirates, ascites and in material recovered by open brain biopsy. Despite treatment with conventional and liposomal amphotericin B the infant patient died.
  
  
  CONCLUSIONS
  Invasive aspergillosis has to be considered in the differential diagnosis of an unusual hyperechogenic brain lesion in very low-birth-weight infants with persistent symptoms and signs of systemic infection despite broad-spectrum antibacterial therapy. Consideration of this diagnosis should result in an aggressive diagnostic work-up to allow early initiation of an appropriate treatment.
authors.affiliation: Division of Neonatology and Pediatric Critical Care, Department of Pediatrics, Children's Hospital, University of Ulm, Eythstr. 24, 89075 Ulm, Germany. hans.fuchs@medizin.uni-ulm.de
authors.forename: Hans
authors.initials: H
authors.lastname: Fuchs
authors.forename: Heike
authors.initials: H
authors.lastname: von Baum
authors.forename: Martina
authors.initials: M
authors.lastname: Meth
authors.forename: Nele
authors.initials: N
authors.lastname: Wellinghausen
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lindner
authors.forename: Helmut
authors.initials: H
authors.lastname: Hummler
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D020314:Central Nervous System Fungal Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D014430:Twins, Monozygotic
chemical_list: D000935:Antifungal Agents