title: Medical management of invasive fungal infections of the central nervous system in pediatric cancer patients.
abstract: Fungal infections of the central nervous system (CNS) are associated with high mortality rates in immunocompromised patients. Surgical intervention is a mainstay of therapy, but not always possible. We describe the use of medical therapy for the treatment of CNS fungal infections in four pediatric cancer patients. Definitive resection was not performed in any patient. All patients initially received combination antifungal therapy with good clinical response; long-term survival was documented in two patients able to transition to long-term azole therapy. Prolonged antifungal therapy is an important option for treating invasive CNS fungal infections when surgery is not feasible.
authors.affiliation: Division of Pediatric Hematology/Oncology, Seattle Children's Hospital, Seattle, Washington; Fred Hutchinson Cancer Research Center, Seattle, Washington; University of Washington, Seattle, Washington.
authors.forename: John H
authors.initials: JH
authors.lastname: Carter
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Lenahan
authors.forename: Gisele E
authors.initials: GE
authors.lastname: Ishak
authors.forename: J Russell
authors.initials: JR
authors.lastname: Geyer
authors.forename: Jessica
authors.initials: J
authors.lastname: Pollard
authors.forename: Janet A
authors.initials: JA
authors.lastname: Englund
mesh_terms: D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D002494:Central Nervous System Infections / Q000188:drug therapy* / Q000401:mortality; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009181:Mycoses / Q000188:drug therapy* / Q000401:mortality; D009369:Neoplasms / Q000150:complications*
chemical_list: D000935:Antifungal Agents
keywords: aspergillus; cancer; central nervous system; pediatric fungal infection; rhizopus