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CASE REPORT
Korean J Pediatr 2000 August;43(8) :1116-1121.
A Case of Primary Multiple Intracerebral Aspergillosis Abscess in Neonate : Treatment with Amphotericin B, Flucytosine and Itraconazole
Byoung Lae Oh (Oh BL)1, Oh Kyung Lee (Lee OK)1, Yong Seog Kim (Kim YS)2, Young Sook Kim (Kim YS)3
1Department of Pediatrics, Presbyterian Medical Center, Chonju, Korea
2Department of Neurosurgery, Presbyterian Medical Center, Chonju, Korea
3Department of Clinical Pathology, Presbyterian Medical Center, Chonju, Korea
Copyright © 2000 by The Korean Pediatric Society
ABSTRACT
Fungal infection of the central nervous system tends to occur mostly in immunosuppressed patients. In the pediatric population, it is usually seen in severely immunocompromised patients, particulary in children with chronic granulomatous disease and hematopoietic malignancies. Although aspergillosis is considered one of the most frequent agents of mycotic infection of the brain, it is especially rare in the neonatal period, and overwhelming multisystem infection is usually diagnosed postmortem. Manifestations include meningitis, meningoencephalitis, granulomata formation, brain abscess, vasculitis, aneurysm formation, infarct and intracranial hemorrhage. We present a neonate who had brain abscess diagnosed by MRI, and aspergillus was found at surgical exploration. There are very few reported survivors of neonatal aspergillosis. We reported a case of primary multiple brain abscess caused by aspergillus associated with severe hypernatremic dehydration and prerenal azotemia. The patient was treated with amphotericin B combined with flucytosine and itraconazole.
Keywords: Brain abscess | Aspergillus | Amphotericin B | Flucytosine | Itraconazole
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