Korean J Nephrol.  2001 Jul;20(4):702-706.

Successful Treatment of Cerebral Aspergillosis with Liposomal Amphotericin B and Minimal Invasive Surgery in a Patient Who Received Renal Transplant 10 Year Ago

• Woo YS
• Kim MJ
• Jang JH
• Hwang SE
• Chung JS
• Sin MJ
• Park JH
• Yang CW
• Kim YS
• Bang BK

Abstract

Aspergillosis involving central nervous system is a rare but life-threatening complication in renal transplant recipients. Its mortality rate approaches almost 100% in spite of various therapeutic regimens. We here report a case of successful treatment of brain aspergillosis with liposomal amphotericin B and endoscopic surgery. A 58-year- old renal transplant recipient admitted due to headache which was developed 5 months ago. He received renal transplant 10 years ago. After admission, brain MRI revealed brain abscess on frontal lobe and this was treated with antibiotics and amphotericin B. On 20 th hospital day, endoscopic surgery via intranasal approach was performed and pathologic finding was consistent with aspergillosis. During treatment, his graft function was progressively deteriorated(serum creatinine level 2.27 mg/dL 4.1 mg/dL) and amphoterinc B was replaced with ambisome. Thereafter, renal function was improved(serum creatinine 2.0 mg/dL on 46 th hospital day). Second operation was performed on 50 th hospital day to remove remnant pathologic lesion, and ambisome was continously adminstered. The brain MRI which was performed on 70 th hospital day showed much improvement. He was discharged with oral antifungal drug(itraconazole). Our case demonstrates the successful treatment of brain aspergillosis with medial treatment and minimal invasive surgery.

Keyword

Renal transplant recipient; Aspergillosis; Liposomal ambisome B; Minimal invasive surgery

MeSH Terms

Amphotericin B*
Anti-Bacterial Agents
Aspergillosis*
Brain
Brain Abscess
Central Nervous System
Creatinine
Frontal Lobe
Headache
Humans
Magnetic Resonance Imaging
Mortality
Transplantation
Transplants
Amphotericin B
Anti-Bacterial Agents
Creatinine