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Aspergillus Nidulans in the CNS

PLEASE HELP domflag at istar.ca
Fri May 16 15:01:50 EST 1997


We are the parents of a twenty month old Baby Boy with a life threatening
disease.   If you can provide any suggestions for helping ou 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.   The biopsy was taken September 13, 1996.

Cause of Infection:  Unknown

Patient's Present Condition:  No neurological deficits.

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 the 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 takne 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 showed 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-cutaneiously to boost immune
function although no immune deficiency has ever been detected.  He had a
negative result when tested for CGD.

An MRI taken on April 2 showed no new lesions and the growth of the fungus
had stopped.

An MRI taken on May 13 showed that the fungus has spread.    We are
increasing the dosage of Itraconazole and are continuing with the Gamma
Interferon.

Any advice would be appreciated.   Thank you.



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