肾病综合征
曲菌病
医学
儿科
重症监护医学
皮肤病科
免疫学
内科学
作者
Aylin Dizi Işık,Gülşen Akkoç,Zeynep Ergenç,S Yilmaz,Sevgi Aslan Tuncay,Burcu Parlak,Pınar Canızcı Erdemli,Didem Büyüktaş Aytaş,Metin Çapar,Özcan Sönmez,Adnan Dağçınar,Sevliya Öcal Demi̇r,Eda Kepenekli
出处
期刊:Pediatric Infectious Disease Journal
[Ovid Technologies (Wolters Kluwer)]
日期:2024-06-10
标识
DOI:10.1097/inf.0000000000004422
摘要
Introduction: Central nervous system (CNS) aspergillosis is an opportunistic infection with an increasing incidence and a high mortality rate. It is seen in immunocompromised patients as well as in immunocompetent patients. Here, we present disseminated aspergillosis in a child with nephrotic syndrome treated with long-term and aggressive systemic antifungal treatment and intraventricular (IVent) liposomal amphotericin B (L-AmB) as well as surgical excision and drainage due to difficulty in management. Case report: A 10-year-old boy with nephrotic syndrome on steroid therapy was admitted with limping and weakness. The cranial magnetic resonance imaging showed multiple intraparenchymal scattered abscesses. The largest one was excised and drained. Abscess culture revealed Aspergillus fumigatus and histopathological examination revealed septate hyphae compatible with Aspergillosis. Intravenous (IV) voriconazole was started, and IV L-AmB was added. The size of lesions and perilesional edema continued to increase, and then IVent L-AmB was added. With IVent and systemic antifungal treatment, regression of the lesions was observed. He was followed up with oral voriconazole and weekly IVent L-AmB. After 2 and a half months, he was re-operated because of increased lesion size, number and perilesional edema, and IV voriconazole and other salvage antifungal therapies were started. Since the lesions had decreased and remained stable, IV voriconazole was switched to oral therapy, and he was followed up as an outpatient. Immunodeficiency diseases were excluded by immunological and genetic tests. Conclusion: Management of central nervous system aspergillosis can be challenging despite long-term and aggressive systemic and IVent antifungal treatment as well as surgical excision and drainage.
科研通智能强力驱动
Strongly Powered by AbleSci AI