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Challenging Treatment of Disseminated Aspergillosis in a Child With Nephrotic Syndrome.
Dizi Isik, Aylin; Akkoç, Gülsen; Ergenç, Zeynep; Yilmaz, Seyhan; Aslan Tuncay, Sevgi; Parlak, Burcu; Canizci Erdemli, Pinar; Büyüktas Aytas, Didem; Abaci Çapar, M Çagla; Sönmez, Özcan; Dagçinar, Adnan; Öcal Demir, Sevliya; Kepenekli, Eda.
Afiliación
  • Dizi Isik A; From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Türkiye.
  • Akkoç G; From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Türkiye.
  • Ergenç Z; From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Türkiye.
  • Yilmaz S; From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Türkiye.
  • Aslan Tuncay S; From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Türkiye.
  • Parlak B; From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Türkiye.
  • Canizci Erdemli P; From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Türkiye.
  • Büyüktas Aytas D; From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Türkiye.
  • Abaci Çapar MÇ; From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Türkiye.
  • Sönmez Ö; Department of Neurosurgery, Marmara University School of Medicine, Istanbul, Türkiye.
  • Dagçinar A; Department of Neurosurgery, Marmara University School of Medicine, Istanbul, Türkiye.
  • Öcal Demir S; From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Türkiye.
  • Kepenekli E; From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University School of Medicine, Istanbul, Türkiye.
Pediatr Infect Dis J ; 43(10): e363-e365, 2024 Oct 01.
Article en En | MEDLINE | ID: mdl-38865571
ABSTRACT

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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aspergillus fumigatus / Anfotericina B / Voriconazol / Antifúngicos / Síndrome Nefrótico Límite: Child / Humans / Male Idioma: En Revista: Pediatr Infect Dis J Asunto de la revista: DOENCAS TRANSMISSIVEIS / PEDIATRIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aspergillus fumigatus / Anfotericina B / Voriconazol / Antifúngicos / Síndrome Nefrótico Límite: Child / Humans / Male Idioma: En Revista: Pediatr Infect Dis J Asunto de la revista: DOENCAS TRANSMISSIVEIS / PEDIATRIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos