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Published on: March 22, 2012
Cerebral aspergillosis in children. Report of three cases
V Cuccia1, M Galarza, J Monges
1Division of Neurosurgery, Hospital Nacional de Pediatría, Buenos Aires, Argentina.
Abstract:
Between March and December of 1997, 3 cases of infantile cerebral aspergillosis appeared in our hospital. All patients presented some kind of immunosuppression associated with clinical findings of intracranial hypertension. After surgery, all cases were histopathologically confirmed and had positive cultures of Aspergillus. The first case was a patient with a history of subtotal resection of supratentorial ependymoma which presented a new enhancing mass on a control CT scan. Brain tumor recidiva was suspected, although, an Aspergillus granuloma was encountered on the tumor bed. Both other cases were found in patients who underwent transplantation: one presented multiple cerebral lesions after a renal transplant, and the other, after a bone marrow transplant, developed a rhinocerebral aspergillosis. The discussion was focused on the clinical findings, images and treatment of this cerebral infectious disease.
Insights
Three infants developed cerebral aspergillosis, a serious Aspergillus infection of the brain, often linked to immunosuppression or prior surgery. Early diagnosis and treatment are crucial for managing this rare but severe fungal infection.
Area of Science:
- Neurology
- Infectious Diseases
- Mycology
Background:
- Infantile cerebral aspergillosis is a rare but severe fungal infection affecting the brain.
- Immunosuppression and prior neurosurgery are significant risk factors.
Observation:
- Three cases of infantile cerebral aspergillosis were observed between March and December 1997.
- Patients presented with symptoms of intracranial hypertension.
- One case involved a post-surgical complication after ependymoma resection; two cases occurred in transplant recipients (renal and bone marrow).
Findings:
- All cases were confirmed histopathologically with positive Aspergillus cultures.
- Cerebral lesions, including an Aspergillus granuloma mimicking tumor recurrence, were identified.
- Rhinocerebral aspergillosis was noted in one post-bone marrow transplant case.
Implications:
- Highlights the importance of considering fungal infections in immunocompromised infants with neurological symptoms.
- Emphasizes the need for prompt diagnosis and appropriate antifungal therapy.
- Underscores the diagnostic challenges, such as differentiating fungal granulomas from tumor recurrence.
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