Date: 26 November 2013
Image c. 3 yr old boy with CNS aspergillosis pt TS. MRI scan pre-amphotericin B
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Notes:
A 3 year old boy, quite active and healthy clinically, who has CNS aspergillosis. He was first seen about 4 months ago for a red eye, which turned out to be panophthalmitis; culture yielded Aspergillus spp. He received 2 weeks of iv amphotericin and was sent home by the ophthalmologists. No h/o eye trauma. He returned 2 weeks ago with focal fits, and the MR showed several lesions bilaterally (including ring enhancing lesions) and normal sinuses, and a brain bx showed fungal hyphae (no culture this time). His immune status (normal WCC and neutrophil function so far) was investigated.
He was given conventional amphotericin for 8 weeks, and switched to oral itraconazole. We had to limit the ampho to 0.7 mg/kg owing to toxicity (mainly hypokalaemia).
The MRI scan was repeated at about 6 weeks, and generally showed good improvement (scans e-h). The enhancement/flare were gone but remained in a few lesions, the lesions themselves were all either gone or much smaller. Further investigations revealed the child was immunocompetent.
Patient was switched from amphotericin to oral itraconazole at week 8 essentially on a clinical assessment. Awaiting follow-up.
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Aspergillosis in the coral sea fan Gorgonia ventalina. Sea fan coral Gorgonia ventalina, Florida Keys, USA. Depth ~5 metres, showing a lesion surrounded by a band of purple tissue. Central areas of the lesion are devoid of coral tissue revealing the underlying axial skeleton. The purple areas are devoid of coral polyps and result from the increased production of purple sclerites (small, non-fused, carbonate skeletal elements). The purpled area also indicates the location of high fungal hyphal density and el
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Aspergillosis in the coral sea fan Gorgonia ventalina. In the Caribbean ond offshore USA the sea fan coral species Gorgonia ventalina is undergoing an epizootic due to Aspergillus sydowii infection. This species of Aspergillus is also known to be associated with food contamination and for opportunistic infection in humans.Taken in San Salvador, Bahamas. Bar represents 5cm. This sea fan was heavily colonized by algae.A -tumours and galls B -lesion C -purplingGalls are composed of axial skeleton and scl
