Aspergillus Nidulans in the CNS

PLEASE HELP domflag at istar.ca
Mon Mar 24 09:31:06 EST 1997


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 a 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 relieved 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 the MRI showed disease had progressed.
The next treatment 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 the 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 sidease 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-cutaneiously to boost immune
function although no immune deficiency has ever been detected.  He had a
negative result when tested for CGD.




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