Brain abscesses in children with cancer

Antunes, Nuno Lobo; Subramanian, Hariharan; DeAngelis, Lisa M.

doi:10.1002/(sici)1096-911x(199807)31:1<19::aid-mpo4>3.0.co;2-2

Cited by 27 publications

(14 citation statements)

References 14 publications

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“…Childhood cancer patients are particularly susceptible to developing BA 19 . In our study, eight children with cancer developed BA, including the three who died.…”

Section: Discussionmentioning

confidence: 71%

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Intracranial suppuration

Leotta¹,

Chaseling²,

Duncan

et al. 2005

J Paediatrics Child Health

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Objective: To evaluate prevalence, age, position, predisposing factors, bacteriology, clinical features and outcomes of children with subdural empyema (SDE) and brain abscess (BA). Design: Retrospective hospital‐based study in a tertiary children's hospital. Methods: Clinical data were reviewed on all children classified as having SDE or BA for 10.75 years from 1 January 1992 to 31 August 2003 at the Royal Alexandra Hospital for Children, Sydney, Australia. Results: Forty‐six children with intracranial suppuration were identified: 26 had BA, 16 had SDE and four children had both SDE and BA. Significant differences between SDE and BA were that: sinusitis was a predisposing factor for SDE (P = 0.01), Streptococcus milleri was the main organism isolated in SDE (P = 0.02), periorbital oedema (P = 0.005) and photophobia (P = 0.02) were clinical features specifically associated with SDE, and 75% of multiple abscesses were in females (P = 0.005). The age distribution of SDE was biphasic, with peaks at <2 years and >7 years. Cases of BA peaked at age 9–11 years. Forty‐eight per cent of all children were between 9 and 13 years old; 20% were <1 year old. All the children with SDE and BA were aged 1 year or less. Three of the 46 children died, all with BA. Eighteen (39.1%) returned to normal and 25 (54.3%) had neurological complications. Neurological complications were more common in the BA group. Conclusion: The mortality rate of intracranial suppuration is low, but morbidity remains high. A high degree of suspicion is needed to diagnose and treat intracranial infections early.

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“…Childhood cancer patients are particularly susceptible to developing BA 19 . In our study, eight children with cancer developed BA, including the three who died.…”

Section: Discussionmentioning

confidence: 71%

“…The association between leukaemia and BA was noted in a study by Antunes et al. 19 in 1998, who reported a poor prognosis for oncology patients who develop BA, particularly those with leukaemia. Oncology patients also show a different spectrum of organisms to the majority, because of their underlying immunosuppression.…”

Section: Discussionmentioning

confidence: 84%

Intracranial suppuration

Leotta¹,

Chaseling²,

Duncan

et al. 2005

J Paediatrics Child Health

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“…The literature search yielded 83 reports of a total of 177 cases of invasive Fusarium infection in patients with haematological diseases as reported in previous reviews (Martino et al, 1994;Boutati & Anaissie, 1997) and other reports (Rabodonirina et al, 1994;Freidank, 1995;Hansson et al, 1995;Lopes et al, 1995;Mohammedi et al, 1995;Raad & Hachem, 1995;Velasco et al, 1995;Wolff & Ramphal, 1995;Arrese et al, 1996;Bleggi-Torres et al, 1996;Chevalet et al, 1996;Krulder et al, 1996;Patterson et al, 1996;Fang et al, 1997;Hennequin et al, 1997;Krcmery et al, 1997;Kumar et al, 1997;Antunes et al, 1998;Game et al, 1998;Sancho et al, 1998;Segal et al, 1998;Yildiran et al, 1998;Girmenia et al, 1999;Mangini & de Camargo, 1999). The patients characteristics are shown in Table I.…”

Section: Resultsmentioning

confidence: 99%

The epidemiology of fusariosis in patients with haematological diseases

Girmenia¹,

Pagano²,

Corvatta³

et al. 2000

Br J Haematol

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Fusariosis has been considered an emerging infection in patients with haematological malignancies. In a multicentre retrospective study on filamentous fungi infections in patients with haematological diseases over a period of 10 years in Italy, fusariosis was documented in six patients from two of the 14 centres with a 0.06% incidence in acute leukaemia. A literature search yielded 177 cases of Fusarium infections in haematological diseases and acute leukaemia accounted for 71% of the underlying conditions. An increase from 0.5 to 3.8 cases per year was observed at the M.D. Anderson Cancer Center of Houston in the periods 1975-85 and 1986-95 respectively. Conversely, only 5.1 and 6.3 cases per year have been reported in the periods 1981-90 and 1991-96, respectively, from the other centres in the world. Half of the cases have been observed in the USA. In Europe, most of the cases have been observed in France and Italy. Invasive fusariosis is a rare complication in haematological diseases, as its overall frequency does not seem to be significantly increased within the last 20 years. However, its epidemiological distribution is not homogeneous and the possibility of local clusters of infections by this deadly pathogen should be carefully considered.

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“…In our review of the literature, we found that Fusarium spp pathology may present across a wide spectrum. Keratitis, 8 endophthalmitis, 9 onychomycosis, 10 11 cutaneous infections, 12 13 peritonitis, 14 fungemia, 15 osteomyelitis, 16 17 septic arthritis, 18 19 20 otitis, 21 sinusitis, 22 23 pneumonia, 24 vertebral abscess, 16 brain abscess, and other central nervous system (CNS) infections 25 26 27 28 29 30 31 32 33 34 are all possible presentations of this fungus. 4 Of general importance are those presentations that commonly serve as portals of entry such as keratitis, endophthalmitis, onychomycosis, and cutaneous infection because these methods of fungal infection can lead to potentially fatal dissemination; 50 to 80% mortality has been seen.…”

Section: Discussionmentioning

confidence: 99%

“…A review of the literature resulted in four prior confirmed cases of Fusarium brain abscesses 27 28 31 34 and several additional cases with probable brain involvement 25 26 29 30 32 33 along with one case of vertebral abscess. 16 Of these cases, only the vertebral abscess patient was immunocompetent.…”

Section: Discussionmentioning

confidence: 99%

Intracranial Fusarium Fungal Abscess in an Immunocompetent Patient: Case Report and Review of the Literature

et al. 2014

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Introduction Fusarium spp is an omnipresent fungal species that may lead to fatal infections in immunocompromised populations. Spontaneous intracranial infection by Fusarium spp in immunocompetent individuals is exceedingly rare. Case Report An immunocompetent 33-year-old Hispanic woman presented with persistent headaches and was found to have a contrast-enhancing mass in the left petrous apex and prepontine cistern. She underwent a subsequent craniotomy for biopsy and partial resection that revealed a Fusarium abscess. She had a left transient partial oculomotor palsy following the operation that resolved over the next few weeks. She was treated with long-term intravenous antifungal therapy and remained at her neurologic baseline 18 months following the intervention. Discussion To our knowledge, this is the first reported case of Fusarium spp brain abscess in an immunocompetent patient. Treatment options include surgical intervention and various antifungal medications. Conclusion This case demonstrates the rare potential of intracranial Fusarium infection in the immunocompetent host, as well as its successful treatment with surgical aspiration and antifungal therapy.

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Brain abscesses in children with cancer

Cited by 27 publications

References 14 publications

Intracranial suppuration

Intracranial suppuration

The epidemiology of fusariosis in patients with haematological diseases

Intracranial Fusarium Fungal Abscess in an Immunocompetent Patient: Case Report and Review of the Literature

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