Successful treatment of aspergillus brain abscess in a child with acute lymphoblastic leukemia

Cerebral aspergillus carries a high mortality in immunocompromised patients . However, favorable outcome can be achieve by the prolonged use of antifun gal agents and the maintenance of adequate drug levels. The authors report a 2-year-old girl who developed an aspergillus brain abscess during treatme nt for acute lymphoblastic leukemia. Predisposing factors for the fungal in fection and details of the antifungal therapy are described. Prolonged trea tment with AmBisome and 5-flucytosine successfully eradicated the lesion, b ut the girl's antileukemic therapy was compromised due to the infection. Sh e developed a central nervous system and bone marrow relapse 9 and 15 month s, respectively, after the initial presentation. The report emphasizes the need for further consideration of effective, long-term antifungal prophylax is and a careful balance between aggressive treatment for severe infection and antileukemic therapy.