{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T22:13:53Z","timestamp":1758406433699},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:p>Invasive fungal infections are rare in children with acute lymphoblastic leukemia. It compromises the antileukemia therapy should it happen. Central nervous system fungal infections carry high mortality. We here report the case of a 6.5-year-old girl who developed multiple central nervous system fungal abscesses possibly due to Aspergillus infection during induction therapy for acute lymphoblastic leukemia who has been successfully managed without compromising antileukemia therapy. She has been receiving antifungal therapy and maintenance chemotherapy for 20 months from diagnosis. We reviewed literature about the optimal duration of therapy for such children as the reported cases duration ranged between 4 and 24 months.<\/jats:p>","DOI":"10.1097\/mph.0000000000000855","type":"journal-article","created":{"date-parts":[[2017,7,20]],"date-time":"2017-07-20T15:32:27Z","timestamp":1500564747000},"page":"e312-e317","source":"Crossref","is-referenced-by-count":3,"title":["Central Nervous System Fungal Infection and Acute Lymphoblastic Leukemia in Children: What is the Optimal Duration of Antifungal Therapy?"],"prefix":"10.1097","volume":"39","author":[{"given":"Harsha P.","family":"Lashkari","sequence":"first","affiliation":[{"name":"KMC Hospitals, Manipal University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Fernandes","sequence":"additional","affiliation":[{"name":"KMC Hospitals, Manipal University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kishan","family":"Alva","sequence":"additional","affiliation":[{"name":"K S Hegde Medical College Academy, Nitte University, Mangalore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santosh","family":"Rai","sequence":"additional","affiliation":[{"name":"KMC Hospitals, Manipal University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230918","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1182\/blood-2014-03-560847","article-title":"Infection-related mortality in children with acute lymphoblastic leukemia: an analysis of infectious deaths on UKALL2003","volume":"124","author":"O\u2019Connor","year":"2014","journal-title":"Blood"},{"key":"R2-20230918","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1046\/j.0933-7407.2003.00931.x","article-title":"Invasive fungal infections are responsible for one-fifth of the infectious deaths in children with ALL","volume":"46","author":"Grigull","year":"2003","journal-title":"Mycoses"},{"key":"R3-20230918","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/S0163-4453(98)80173-4","article-title":"An EORTC multicentre prospective survey of invasive aspergillosis in haematological patients: diagnosis and therapeutic outcome. EORTC Invasive Fungal Infections Cooperative Group","volume":"37","author":"Denning","year":"1998","journal-title":"J Infect"},{"key":"R4-20230918","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.ijid.2007.01.013","article-title":"Central nervous system aspergillosis in children: a systematic review of reported cases","volume":"11","author":"Dotis","year":"2007","journal-title":"Int J Infect Dis"},{"key":"R5-20230918","doi-asserted-by":"crossref","first-page":"337","DOI":"10.3324\/haematol.2010.030825","article-title":"Impact of invasive fungal disease on the chemotherapy schedule and event-free survival in acute leukemia patients who survived fungal disease: a case-control study","volume":"96","author":"Even","year":"2011","journal-title":"Haematologica"},{"key":"R6-20230918","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1093\/jac\/dkp507","article-title":"Overall survival and fungal infection-related mortality in patients with invasive fungal infection and neutropenia after myelosuppressive chemotherapy in a tertiary care centre from 1995 to 2006","volume":"65","author":"Hahn-Ast","year":"2010","journal-title":"J Antimicrob Chemother"},{"key":"R7-20230918","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1002\/pbc.23005","article-title":"Invasive fungal infections in pediatric oncology","volume":"56","author":"Mor","year":"2011","journal-title":"Pediatr Blood Cancer"},{"key":"R8-20230918","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1007\/s13277-014-2649-7","article-title":"Invasive fungal infection in patients receiving chemotherapy for hematological malignancy: a multicenter, prospective, observational study in China","volume":"36","author":"Sun","year":"2015","journal-title":"Tumour Biol"},{"key":"R9-20230918","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1086\/313445","article-title":"Aspergillosis in children with cancer: a 34-year experience","volume":"29","author":"Abbasi","year":"1999","journal-title":"Clin Infect Dis"},{"key":"R10-20230918","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1002\/(SICI)1096-911X(199807)31:1<19::AID-MPO4>3.0.CO;2-2","article-title":"Brain abscesses in children with cancer","volume":"31","author":"Antunes","year":"1998","journal-title":"Med Pediatr Oncol"},{"key":"R11-20230918","first-page":"991","article-title":"Fungal brain abscesses in leukemia","volume":"43","author":"Athanassiadou","year":"2006","journal-title":"Indian Pediatr"},{"key":"R12-20230918","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1227\/00006123-199504000-00032","article-title":"Invasive central nervous system aspergillosis: cure with liposomal amphotericin B, itraconazole, and radical surgery\u2014case report and review of the literature","volume":"36","author":"Coleman","year":"1995","journal-title":"Neurosurgery"},{"key":"R13-20230918","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1046\/j.1439-0507.1999.00496.x","article-title":"Five-year-survey of invasive aspergillosis in a paediatric cancer centre. Epidemiology, management and long-term survival","volume":"42","author":"Groll","year":"1999","journal-title":"Mycoses"},{"key":"R14-20230918","doi-asserted-by":"crossref","first-page":"455","DOI":"10.3109\/08880019409140548","article-title":"Rhinocerebral aspergillosis in a child with acute lymphoblastic leukemia","volume":"11","author":"Jain","year":"1994","journal-title":"Pediatr Hematol Oncol"},{"key":"R15-20230918","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S0887-8994(98)00021-6","article-title":"Myelopathy resulting from invasive aspergillosis","volume":"19","author":"Koh","year":"1998","journal-title":"Pediatr Neurol"},{"key":"R16-20230918","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1080\/08880010050120863","article-title":"Successful treatment of aspergillus brain abscess in a child with acute lymphoblastic leukemia","volume":"17","author":"Ng","year":"2000","journal-title":"Pediatr Hematol Oncol"},{"key":"R17-20230918","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1007\/s11046-012-9563-6","article-title":"Multiple fungal brain abscesses in a child with acute lymphoblastic leukemia","volume":"174","author":"Patiroglu","year":"2012","journal-title":"Mycopathologia"},{"key":"R18-20230918","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1097\/MPH.0b013e31815c255f","article-title":"Rhinocerebral mucormycosis in a child with acute lymphoblastic leukemia: a case report","volume":"30","author":"Popa","year":"2008","journal-title":"J Pediatr Hematol Oncol"},{"key":"R19-20230918","doi-asserted-by":"crossref","first-page":"e384","DOI":"10.1097\/MPH.0000000000000351","article-title":"Brain abscesses due to Aspergillus nidulans infection during induction chemotherapy for acute lymphoblastic leukemia","volume":"37","author":"Sadarangani","year":"2015","journal-title":"J Pediatr Hematol Oncol"},{"key":"R20-20230918","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1097\/00043426-200208000-00017","article-title":"Rhinocerebral mucormycosis in a boy with recurrent acute lymphoblastic leukemia: long-term survival with systemic antifungal treatment","volume":"24","author":"Wehl","year":"2002","journal-title":"J Pediatr Hematol Oncol"},{"key":"R21-20230918","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/BF01372092","article-title":"Disseminated mucormycosis: report of a successfully treated immunosuppressed child with clinical, radiographic and pathological findings","volume":"26","author":"Celgow","year":"1996","journal-title":"Pediatr Radiol"},{"key":"R22-20230918","doi-asserted-by":"crossref","first-page":"236","DOI":"10.4103\/0971-5851.107104","article-title":"Cerebral aspergillus infection in pediatric acute lymphoblastic leukemia induction therapy","volume":"33","author":"Prakash","year":"2012","journal-title":"Indian J Med Paediatr Oncol"},{"key":"R23-20230918","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1002\/pbc.21814","article-title":"Management of brain abscesses in children treated for acute lymphoblastic leukemia","volume":"52","author":"Lackner","year":"2009","journal-title":"Pediatr Blood Cancer"},{"key":"R24-20230918","doi-asserted-by":"crossref","first-page":"4569","DOI":"10.1128\/JCM.38.12.4569-4576.2000","article-title":"Acrophialophora fusispora brain abscess in a child with acute lymphoblastic leukemia: review of cases and taxonomy","volume":"38","author":"Al-Mohsen","year":"2000","journal-title":"J Clin Microbiol"},{"key":"R25-20230918","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1002\/(SICI)1096-911X(199905)32:5<344::AID-MPO6>3.0.CO;2-6","article-title":"Fungal colonization and infection in children with acute leukemia and lymphoma during induction therapy","volume":"32","author":"Gozdasoglu","year":"1999","journal-title":"Med Pediatr Oncol"},{"key":"R26-20230918","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1080\/08880010500278665","article-title":"Successful treatment of aspergillus brain abscess in a child with acute lymphoblastic leukemia and liver failure","volume":"22","author":"Sterba","year":"2005","journal-title":"Pediatr Hematol Oncol"},{"key":"R27-20230918","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/BF01690733","article-title":"Fatal meningoencephalitis caused by Scedosporium inflatum (Scedosporium prolificans) in a child with lymphoblastic leukemia","volume":"14","author":"Madrigal","year":"1995","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"R28-20230918","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1097\/MPH.0b013e3181bbc516","article-title":"Zygomycetes infections in pediatric hematology oncology patients: a case series and review of the literature","volume":"31","author":"Dehority","year":"2009","journal-title":"J Pediatr Hematol Oncol"},{"key":"R29-20230918","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1097\/00043426-200405000-00009","article-title":"Resolution of orbitocerebral aspergillosis during combination treatment with voriconazole and amphotericin plus adjunctive cytokine therapy","volume":"26","author":"Bethell","year":"2004","journal-title":"J Pediatr Hematol Oncol"},{"key":"R30-20230918","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1002\/pbc.25331","article-title":"Medical management of invasive fungal infections of the central nervous system in pediatric cancer patients","volume":"62","author":"Carter","year":"2015","journal-title":"Pediatr Blood Cancer"},{"key":"R31-20230918","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1055\/s-2007-973494","article-title":"Magnetic resonance imaging and angiography in cerebral fungal vasculitis","volume":"30","author":"Christophe","year":"1999","journal-title":"Neuropediatrics"},{"issue":"suppl 1","key":"R32-20230918","first-page":"S37","article-title":"Aspergilloma of the brain: an overview","volume":"51","author":"Nadkarni","year":"2005","journal-title":"J Postgrad Med"},{"key":"R33-20230918","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1086\/318483","article-title":"Aspergillosis case-fatality rate: systematic review of the literature","volume":"32","author":"Lin","year":"2001","journal-title":"Clin Infect Dis"},{"key":"R34-20230918","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1093\/clinids\/19.3.402","article-title":"Brain abscess following marrow transplantation: experience at the Fred Hutchinson Cancer Research Center, 1984-1992","volume":"19","author":"Hagensee","year":"1994","journal-title":"Clin Infect Dis"},{"key":"R35-20230918","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1136\/adc.63.4.436","article-title":"Mycotic intracranial abscesses during induction treatment for acute lymphoblastic leukaemia","volume":"63","author":"Foreman","year":"1988","journal-title":"Arch Dis Child"},{"key":"R36-20230918","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/S1042-3680(18)30673-9","article-title":"Neurosurgical infections in the compromised host","volume":"3","author":"Hall","year":"1992","journal-title":"Neurosurg Clin N Am"}],"container-title":["Journal of Pediatric Hematology\/Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00043426-201708000-00019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T04:09:07Z","timestamp":1695010147000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00043426-201708000-00019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8]]},"references-count":36,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1097\/mph.0000000000000855","relation":{},"ISSN":["1077-4114"],"issn-type":[{"value":"1077-4114","type":"print"}],"subject":[],"published":{"date-parts":[[2017,8]]}}}