All issues > Volume 43(8); 2000

Case Report

J Korean Pediatr Soc. 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 BL Oh¹, Oh Kyung OK Lee¹, Yong Seog YS Kim², Young Sook YS 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

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