Child's Nervous System

, Volume 26, Issue 2, pp 149–154 | Cite as

Atypical presentation of chronic granulomatous disease in an adolescent boy with frontal lobe located Aspergillus abscess mimicking intracranial tumor

  • Turkan Patiroglu
  • Ekrem Unal
  • Ali Yikilmaz
  • M. Yavuz Koker
  • Mustafa K. Ozturk
Case-Based Update

Abstract

Background

Chronic granulomatous disease (CGD) is an uncommon congenital phagocyte disorder characterized by recurrent life-threatening infections. CGD generally present with recurrent suppurative infections, however, intracranial fungal abscess complicating CGD may cause a diagnostic problem to anyone unfamiliar with its clinical and radiological features.

History

We report the case of a 16-year-old boy who was consulted with a differential diagnosis of an intracranial tumor. The clues of his medical history and physical examination made us consider the diagnosis of CGD. Cytometric dihydrorhodamine assay and genotyping confirmed an autosomal recessive CGD. He was successfully treated without any complication or sequel for 18 months follow-up period with surgery and interferon-γ, in addition with, liposomal amphotericin B and voriconazole that were found to be sensitive to the Aspergillus fumigates, which had been grown from the culture of the abscess cavity.

Discussion

We discuss the pathogenesis, radiological techniques, and management of cerebral Aspergillus abscess in a patient with CGD.

Conclusion

Presentation of CGD with a cerebral Aspergillus abscess, mimicking a brain tumor is extremely rare in children; clinicians and neurosurgeons must be aware. The best management modality for cerebral Aspergillus abscess is to be vigilant about the disease, whereas adjuvant surgical and medical therapy with a close follow-up must be warranted for all cases.

Keywords

Aspergillus Brain abscess Children Chronic granulomatous disease 

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Turkan Patiroglu
    • 1
  • Ekrem Unal
    • 2
  • Ali Yikilmaz
    • 3
  • M. Yavuz Koker
    • 4
  • Mustafa K. Ozturk
    • 5
  1. 1.Department of Pediatrics, Division of Pediatric Hematology and Immunology, Faculty of MedicineErciyes UniversityKayseriTurkey
  2. 2.Department of Pediatrics, Division of Pediatric Hematology and Oncology, Faculty of MedicineErciyes UniversityKayseriTurkey
  3. 3.Department of Radiology, Division of Pediatric Radiology, Faculty of MedicineErciyes UniversityKayseriTurkey
  4. 4.Division of ImmunologyDiskapi Research Hospital of Children’ DiseaseAnkaraTurkey
  5. 5.Department of Pediatrics, Division of Pediatric Infectious Disease, Faculty of MedicineErciyes UniversityKayseriTurkey

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