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Myelopathy resulting from invasive aspergillosis
1Division of Neurology, Children's Hospital Los Angeles, University of Southern California, USA.
Pediatric Neurology
|September 23, 1998
Summary
Invasive aspergillosis can present as myelopathy, a rare spinal cord condition, in severely immunocompromised children with leukemia. This fatal condition requires prompt physician awareness for early diagnosis and intervention.
Area of Science:
- Medical Mycology
- Pediatric Oncology
- Neurology
Background:
- Invasive aspergillosis is a severe fungal infection primarily affecting immunocompromised individuals.
- Myelopathy, a spinal cord dysfunction, is an infrequent manifestation of invasive aspergillosis.
Observation:
- This case series details three pediatric patients with advanced leukemia who presented with myelopathy as the initial sign of invasive aspergillosis.
- Patients experienced progressive neurological deficits, including weakness, pain, and loss of sensation, culminating in complete myelopathy.
- Magnetic resonance imaging revealed multiple brain lesions in one patient, indicating disseminated disease.
Findings:
- All three patients, profoundly immunosuppressed due to chemotherapy and antibiotics, succumbed to invasive aspergillosis within one month of myelopathy onset.
- Despite administration of antifungal therapies, the disease progression was rapid and uniformly fatal.
Implications:
- Healthcare providers managing immunocompromised children must consider invasive aspergillosis presenting as myelopathy.
- Early recognition of this rare neurological complication is crucial for timely diagnosis and management of invasive aspergillosis in pediatric patients.