MYELOPATHY RESULTING FROM INVASIVE ASPERGILLOSIS

Aspergillus, a ubiquitous mold, may cause invasive and fatal disease i n immunosuppressed patients. Myelopathy is an uncommon presentation of invasive aspergillosis, This report describes three children admitted to the hospital between 1988 and 1995 who developed myelopathy as the first evidence of invasive aspergillosis. All had advanced leukemia a nd were profoundly immunosuppressed because of chemotherapy and broad- spectrum antibiotics. Weakness and pain presented first; then, sensati on to pain and temperature was lost 2 to 6 days later, followed by com plete myelopathy, Multiple brain lesions were seen on magnetic resonan ce imaging in one patient. Despite antifungal therapy, aspergillosis p roved fatal within 1 month of onset of myelopathy in all patients. Phy sicians caring for immunocompromised children should be aware of myelo pathy as a presentation of invasive aspergillosis. (C) 1998 by Elsevie r Science Inc. All rights reserved.