Disseminated phaeohyphomycosis due to Cladophialophora bantiana in an immunocompetent child.

Autor: Mahesan A; Center of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, AIIMS, New Delhi, India., Mohammed AS; Center of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, AIIMS, New Delhi, India., Kamila G; Center of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, AIIMS, New Delhi, India., Jauhari P; Center of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, AIIMS, New Delhi, India., Chakrabarty B; Center of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, AIIMS, New Delhi, India., Das S; Department of Pathology, AIIMS, New Delhi, India., Das P; Department of Pathology, AIIMS, New Delhi, India., Suri V; Department of Pathology, AIIMS, New Delhi, India., Gourav S; Department of Microbiology, AIIMS, New Delhi, India., Xess I; Department of Microbiology, AIIMS, New Delhi, India., Kumar A; Department of Radiology, AIIMS, New Delhi, India., Gulati S; Center of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, AIIMS, New Delhi, India. Electronic address: sheffaligulati@gmail.com.
Jazyk: angličtina
Zdroj: Journal de mycologie medicale [J Mycol Med] 2024 Jun; Vol. 34 (2), pp. 101467. Date of Electronic Publication: 2024 Feb 24.
DOI: 10.1016/j.mycmed.2024.101467
Abstrakt: A 3-year-old boy presented with acute headache, vomiting and right focal clonic seizures without history of fever, joint pain or altered sensorium. Neuroimaging showed multifocal contrast enhancing lesions with significant perilesional edema. CECT chest and abdomen showed multiple variable sized nodules in the lungs and hypodense lesion in liver with mesenteric lymphadenopathy. There was persistent eosinophilia with maximum upto 35 %. Liver biopsy and brain biopsy revealed Cladophialophora bantiana. He was treated with IV liposomal amphotericin and voriconazole for 6 weeks with repeat neuroimaging showing more than 50 % resolution of the intracranial lesions. He was transitioned to oral combination of flucytosine and voriconazole. At 14 months follow-up, he remained symptom free with complete radiological resolution of the lesions and no eosinophilia. High suspicion, an aggressive approach in obtaining microbiological diagnosis and timely combination antifungal therapy may give satisfactory outcome without surgery.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier Masson SAS.)
Databáze: MEDLINE
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