Atypical presentation of chronic granulomatous disease in an adolescent boy with frontal lobe located Aspergillus abscess mimicking intracranial tumor.
BACKGROUND
Chronic granulomatous disease (CGD) is an uncommon congenital phagocyte disorder characterized by recurrent life-threatening infections. CGD generally present with recurrent suppurative infections, however, intracranial fungal abscess complicating CGD may cause a diagnostic problem to anyone unfamiliar with its clinical and radiological features.


METHODS
We report the case of a 16-year-old boy who was consulted with a differential diagnosis of an intracranial tumor. The clues of his medical history and physical examination made us consider the diagnosis of CGD. Cytometric dihydrorhodamine assay and genotyping confirmed an autosomal recessive CGD. He was successfully treated without any complication or sequel for 18 months follow-up period with surgery and interferon-gamma, in addition with, liposomal amphotericin B and voriconazole that were found to be sensitive to the Aspergillus fumigates, which had been grown from the culture of the abscess cavity.


CONCLUSIONS
We discuss the pathogenesis, radiological techniques, and management of cerebral Aspergillus abscess in a patient with CGD.


CONCLUSIONS
Presentation of CGD with a cerebral Aspergillus abscess, mimicking a brain tumor is extremely rare in children; clinicians and neurosurgeons must be aware. The best management modality for cerebral Aspergillus abscess is to be vigilant about the disease, whereas adjuvant surgical and medical therapy with a close follow-up must be warranted for all cases.
Department of Pediatrics, Division of Pediatric Hematology and Immunology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
Turkan
T
Patiroglu
Ekrem
E
Unal
Ali
A
Yikilmaz
M Yavuz
MY
Koker
Mustafa K
MK
Ozturk
D000293:Adolescent; D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D005625:Frontal Lobe / Q000378:metabolism / Q000473:pathology*; D006105:Granulomatous Disease, Chronic / Q000175:diagnosis* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D020953:Neuroaspergillosis / Q000175:diagnosis* / Q000473:pathology* / Q000628:therapy