Related Experiment Videos
[Multiple aspergillus brain abscess complicated with systemic lupus erythematosus--case report]
A Sugawara1, K Ebina, T Hirano
1Department of Neurosurgery, Nakadohri Hospital, Akita.
Neurologia Medico-Chirurgica
|December 1, 1991
Summary
Intraventricular miconazole via an Ommaya reservoir effectively treated central nervous system aspergillosis in a lupus patient. This approach offers a promising therapeutic option for complex fungal brain infections.
Area of Science:
- Neurology
- Infectious Diseases
- Neurosurgery
Background:
- Systemic lupus erythematosus (SLE) with nephritis presents complex management challenges.
- Fungal infections, particularly Aspergillus, can complicate immunosuppressive therapy in SLE patients.
Observation:
- A 15-year-old female with lupus nephritis developed a lung abscess followed by multiple brain abscesses.
- Standard treatments for brain abscesses, including intrathecal miconazole, were ineffective.
- Surgical intervention with an Ommaya reservoir enabled direct intraventricular antifungal administration.
Findings:
- Aspergillus was identified as the causative agent of the brain abscesses.
- Intraventricular miconazole administration via an Ommaya reservoir led to the gradual resolution of brain abscesses.
- Recurrence was managed with combined intravenous and intraventricular miconazole, followed by complete surgical removal.
Implications:
- Intraventricular miconazole through an Ommaya reservoir is a viable and effective treatment for central nervous system aspergillosis.
- This case highlights the importance of considering invasive fungal infections in immunocompromised patients with neurological complications.
- Ommaya reservoirs offer a targeted drug delivery system for refractory CNS infections.