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A Case of Primary Multiple Intracerebral Aspergillosis Abscess in Neonate : Treatment with Amphotericin B, Flucytosine and Itraconazole

Journal of the Korean Pediatric Society 2000;43(8):1116-1121.
Published online August 15, 2000.
A Case of Primary Multiple Intracerebral Aspergillosis Abscess in Neonate : Treatment with Amphotericin B, Flucytosine and Itraconazole
Byoung Lae Oh1, Oh Kyung Lee1, Yong Seog Kim2, Young Sook Kim3
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
국균(Aspergillus)증에 의한 신생아 원발성 다발성 뇌농양의 치험 1례
오병래1, 이오경1, 김용석2, 김영숙3
1전주예수병원 소아과
2전주예수병원 신경외과
3전주예수병원 임상병리과
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.
Key Words: Brain abscess, Aspergillus, Amphotericin B, Flucytosine, Itraconazole


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