Successful treatment of multiple Pseudallescheria boydii brain abscesses and ventriculitis/ependymitis in a 2-year-old child after a near-drowning episode

• DOI: 10.1007/s00381-005-1151-3
• Publication Date: 2005-04-29T15:36:18Z
• Authors: Kay Mursch; Svorad Trnovec; Heinrich Ratz; Detlef Hammer; Regine Horré; Albrecht Klinghammer; Sybren de Hoog; Julianne Behnke-M...
• Keywords: Male; 0303 health sciences; Neurosurgery; Brain Abscess; Infant; Magnetic Resonance Imaging; Anti-Bacterial Agents; 3. Good health; Pseudallescheria; 03 medical and health sciences; Near Drowning; Mycetoma; Humans; Encephalomyelitis

We report on a cerebral infection by Pseudallescheria boydii in a 21-month-old boy after a near-drowning episode. MRI revealed multiple (> 60) intracerebral abscesses.The surgical therapy included CSF drainage and microsurgical resection of one abscess for microbiological diagnosis. Antimycotic therapy included terbinafine and intraventricular caspofungin in addition to voriconazole.Systemic side effects of chemotherapy were not observed. After placement of a ventriculoperitoneal shunt, the boy was transferred to a rehabilitation clinic and improved neurologically. After 20 months, MRI documented a continuing remission of the disease.Our case proves that an aggressive treatment should be undertaken and can be successful in CNS pseudallescheriasis.