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Multiple intracranial fungal abscesses in an immunocompetent infant treated surgically
Ashutosh Khandelwal1, Noufal Basheer1, Ashok K Mahapatra1
1Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Abstract:
Intracerebral abscess are rare in neonates and infants. We present a rare case of 4-month-old immunocompetent infant with multiple intracranial fungal abscess. Right frontoparietal craniotomy was done with excision of multicystic mass containing 200cc of dirty colored fluid. Biopsy and culture of abscess came as Aspergillus fumigates. Patient received parental amphotericin B. An immunocompetent infant with intracranial aspergillosis is rare. We advocate combination of surgical excision with parental amphotericin B as best way to achieve good result.
Insights
This case study highlights a rare instance of fungal brain abscess in an infant. Surgical removal combined with antifungal medication proved effective for this immunocompetent child.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Mycology
Background:
- Intracerebral abscesses are uncommon in neonates and infants.
- Fungal brain infections, particularly aspergillosis, are exceedingly rare in immunocompetent infants.
Observation:
- A 4-month-old immunocompetent infant presented with multiple intracranial fungal abscesses.
- Surgical excision of a large multicystic mass (200cc) was performed via right frontoparietal craniotomy.
- Biopsy and culture confirmed Aspergillus fumigatus as the causative agent.
Findings:
- The infant received intravenous amphotericin B post-surgery.
- Successful treatment was achieved through a combination of surgical intervention and antifungal therapy.
Implications:
- This case underscores the importance of considering fungal etiologies in infant brain abscesses, even in immunocompetent individuals.
- Combined surgical excision and systemic antifungal treatment (e.g., amphotericin B) is recommended for optimal outcomes in intracranial aspergillosis.
- Further research into the optimal management of pediatric intracranial fungal infections is warranted.
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