Aspergillus Nidulans in the CNS
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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