title: Current approaches to management of cerebral fungal infection in pediatric patients with hematologic disorders.
abstract: We report 2 pediatric cases of cerebral fungal infection. A patient with severe aplastic anemia developed an Aspergillus species brain abscess and pulmonary aspergillosis after peripheral blood stem cell transplantation. Despite administration of micafungin, amphotericin B, and flucytosine, the patient died 2 months after the transplantation because of underlying pulmonary aspergillosis. Another patient with acute myelogenous leukemia developed a huge brain abscess with histopathologic findings suspicious of mucormycosis. This patient was cured with combination therapy of antifungal agents and intensive surgery, without sequelae. It is important to perform aggressive multimodality treatment, when indicated, including surgical intervention, even if in myelosuppression.
authors: Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan. t-satou@jacls.jp
authors: Tomonobu
authors: T
authors: Sato
authors: Makoto
authors: M
authors: Kaneda
authors: Mizuho
authors: M
authors: Ichikawa
authors: Daisuke
authors: D
authors: Suzuki
authors: Atsuko
authors: A
authors: Nakagawa
authors: Ryoji
authors: R
authors: Kobayashi
mesh_terms: D000293:Adolescent; D000666:Amphotericin B / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D001228:Aspergillosis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D020314:Central Nervous System Fungal Infections / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D002648:Child; D004338:Drug Combinations; D054714:Echinocandins / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D005437:Flucytosine / Q000008:administration & dosage; D005500:Follow-Up Studies; D006084:Graft Rejection; D006402:Hematologic Diseases / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D055666:Lipopeptides; D008074:Lipoproteins / Q000008:administration & dosage; D008279:Magnetic Resonance Imaging; D008297:Male; D000077551:Micafungin; D009091:Mucormycosis / Q000175:diagnosis* / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D004338:Drug Combinations; D054714:Echinocandins; D055666:Lipopeptides; D008074:Lipoproteins; D000666:Amphotericin B; D005437:Flucytosine; D000077551:Micafungin