Cerebral aspergillosis in an infant with corticosteroid-resistant nephrotic syndrome

Pediatr Nephrol. 2003 May;18(5):450-3. doi: 10.1007/s00467-003-1113-5. Epub 2003 Mar 18.

Abstract

Cerebral aspergillosis is a devastating disease in patients with a compromised immune system. A unique case of a male infant with corticosteroid-resistant nephrotic syndrome complicated by pulmonary and cerebral aspergillosis is described. The patient rapidly developed coma and neurological symptoms and died soon thereafter. Central nervous system aspergillosis was diagnosed radiologically and by detection of Aspergillus DNA and antigen (galactomannan) in blood and cerebrospinal fluid. Moderate immunosuppressive therapy and antifungal phagocytic dysfunction due to nephrotic syndrome per se may have contributed to the occurrence of invasive aspergillosis in our patient. Awareness of this serious complication and early application of diagnostic procedures and antifungal therapy may improve the dismal outcome.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / adverse effects*
  • Aspergillus fumigatus* / isolation & purification
  • Drug Resistance
  • Fatal Outcome
  • Humans
  • Immunocompromised Host
  • Infant
  • Male
  • Nephrotic Syndrome / complications*
  • Nephrotic Syndrome / drug therapy*
  • Nephrotic Syndrome / immunology
  • Neuroaspergillosis / diagnostic imaging
  • Neuroaspergillosis / etiology*
  • Neuroaspergillosis / immunology
  • Tomography, X-Ray Computed

Substances

  • Adrenal Cortex Hormones