Aspergillus Nidulans in the CNS

Roz Cundell rcundell at dti.net
Fri Mar 21 23:04:23 EST 1997


On 18 Mar 1997 18:52:11 GMT, "PLEASE HELP" <domflag at istar.ca> wrote:

>Please Help - 
>We are the parents of a twenty month old Baby Boy with a life threatening
>disease.   To our knowledge this is the first case of  fungal infection of
>this type known anywhere in the world.   If you can provide any suggestions
>for helping our little boy we would be most grateful.   
>
>Infection:  Aspergillus Nidulans in the Central Nervous System.   The
>fungus surrounds the base of the brain and is present in other locations on
>the covering of the meninges.   This was diagnosed following a biopsy taken
>from his lumbar region.  Biopsy was taken September 13, 1996.
>
>Cause of Infection:  Unknown
>
>Patient's Present Condition:    No neurological deficits.   Hydrocephalus
>was releived surgically.
>
>Course of Treatment:  Began treatment in September on Amphotericin B and
>5FC given by IV.  Treatment was determined to be unsuccessful.   After one
>month MRI showed disease had progressed. 
>The next reatment was Amphotericin Liposomal given by IV and Oral
>Itraconazole.   An MRI taken one month after this treatment was started,
>appeared to show a slight reduction in the size of the fungal growths,
>however a followup MRI taken thirty days later showed the fungus was once
>again growing.   At this point the decision was made to put in a reservoir
>to administer ampho B directly into his CSF.   On January 9, 1997 a second
>biopsy was taken from his spine.   The biopsy confirmed the fungus was
>aspergillus, but the cultures would not grow so it could not be confirmed
>the fungus was Nidulans.
>An MRI taken February 3, 1997 has shown that the fungus increased in size
>considerably even with this treatment and there were new lesions.
>After this MRI the medication was switched to Itraconazole only.   On March
>3 an MRI was taken showing the progression of the disease was virtually
>stopped.   Since that time Itraconazole doses have been doubled in hope
>this will reduce the fungal lesions.
>He is also being given Gamma Interferon sub-cutaneously to boost immune
>function although no immune deficiency has ever been detected.    He had a
>negative result when tested for CGD.
>
Since the host defences against Aspergillus are mediated by low number
or malfunction the granuluocytes and phagocytes cellular transfusions,
IV immune globulin and surgery should be considered



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