Management of brain abscesses in children treated for acute lymphoblastic leukemia.
Brain abscesses in children with leukemia or other malignancies are rare and potentially fatal. We report on four children who developed brain abscesses during treatment for acute lymphoblastic leukemia (ALL). All patients received multimodal broad-spectrum antibiotic therapy and liposomal amphotericin-B in combination with hyperbaric oxygen. First-line antimicrobial treatment was modified when a causative organism was isolated. All four patients survived, with two patients showing complete resolution of neurological and MRI abnormalities and with two patients still having residual lesions. To date, all patients are in remission with three patients still receiving antileukemic therapy. Brain abscesses can be successfully managed by a multimodality approach even in severely immunocompromised cancer patients.
Lackner
Herwig
H
Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology, Medical University of Graz, Graz, Austria. herwig.lackner@meduni-graz.at
Sovinz
Petra
P
Benesch
Martin
M
Smolle-Jüttner
Freyja
F
Mokry
Michael
M
Schwinger
Wolfgang
W
Moser
Andrea
A
Urban
Christian
C
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000150:complications* / Q000188:drug therapy*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents