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Disseminated miliary cerebral candidiasis
1Department of Radiology, Veterans General Hospital-Kaohsiung, National Yang Ming University, National Defense Medical Center, Taiwan, Republic of China.
Abstract:
We present a case of disseminated intracranial infection by Candida albicans in a 5-year-old girl who had fever and a change of consciousness after surgery for complex congenital heart malformation. MR imaging revealed multiple small ring-enhancing hemorrhagic abscesses. One year after antifungal treatment, the abscesses and ventriculomegaly were almost completely resolved. The patient was discharged in a stable but vegetative condition.
Insights
A disseminated Candida albicans brain infection occurred in a child post-heart surgery. Antifungal treatment led to abscess resolution, but the patient remained in a vegetative state.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Medical Imaging
Background:
- Complex congenital heart malformation surgery can predispose patients to opportunistic infections.
- Disseminated fungal infections, particularly Candida albicans, pose significant risks in immunocompromised pediatric patients.
Observation:
- A 5-year-old girl developed fever and altered consciousness following complex congenital heart surgery.
- Magnetic Resonance (MR) imaging identified multiple small, ring-enhancing, hemorrhagic abscesses within the brain.
Findings:
- The intracranial abscesses and associated ventriculomegaly showed significant resolution after one year of targeted antifungal therapy.
- Despite successful treatment of the infection, the patient's neurological outcome was poor, resulting in a persistent vegetative state.
Implications:
- This case highlights the potential for severe central nervous system candidiasis in pediatric patients with complex congenital heart disease.
- Early diagnosis and aggressive antifungal treatment are crucial, but neurological sequelae can still be profound.
- Further research into preventative strategies and neuroprotective measures is warranted for this vulnerable population.