{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T10:49:07Z","timestamp":1782211747095,"version":"3.54.5"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,10]]},"abstract":"<jats:p>\n                    \u2713Central nervous system (CNS) aspergillosis remains a daunting diagnosis. This opportunistic mycosis historically carries a mortality rate approaching 100% in immunocompromised patients, with death ensuing within days after the onset of neurological symptoms. From their literature review, the authors concluded that children contracting CNS aspergillosis while undergoing systemic chemotherapy for leukemias represent a particularly unfortunate prognostic group. Antifungal medications prove ineffective for treating CNS aspergillosis in patients immunocompromised because of their chemotherapy regimens. In contrast, withholding chemotherapy to reverse immunosuppression, thereby improving the efficacy of antifungal medications, allows for progression of the primary leukemic disease. The authors present a series of four immunosuppressed patients whose course of treatment for leukemia was complicated by CNS\n                    <jats:italic>Aspergillus<\/jats:italic>\n                    sp. abscesses. Multiple cerebral fungal abscesses developed in two patients and a single cerebral abscess developed in two. All four patients underwent frameless stereotactic resection of the aspergilloma. All children later experienced resolution of their CNS infections and full neurological recovery. At 2- to 4-year follow ups, one patient has died of leukemia and the other three continue to thrive without evidence of recurrent aspergillosis. Given the grave natural history cited in the literature for this disease when medical treatment is instituted alone, the authors stress the crucial role of stereotactic neurosurgery for the intelligent treatment of immunocompromised children suspected of harboring a CNS aspergilloma abscesses. The authors propose that the goal for successful treatment in these patients should be gross-total resection of the abscess, its wall, and its capsule.\n                  <\/jats:p>","DOI":"10.3171\/ped.2005.103.4.0374","type":"journal-article","created":{"date-parts":[[2010,8,27]],"date-time":"2010-08-27T06:02:54Z","timestamp":1282888974000},"page":"374-378","source":"Crossref","is-referenced-by-count":5,"title":["Improved survival in central nervous system aspergillosis: a series of immunocompromised children with leukemia undergoing stereotactic resection of aspergillomas"],"prefix":"10.3171","volume":"103","author":[{"given":"Charles A.","family":"Middelhof","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William G.","family":"Loudon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Muhonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Xavier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarence S.","family":"Greene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Neurology","first-page":"473","article-title":"Aspergillosis of the nervous system.","volume":"32","author":"Beal","year":"1982"},{"key":"b2","series-title":"Australas Radiol","first-page":"338","article-title":"Central nervous system aspergillus infection complicating renal transplantation.","volume":"45","author":"Coates","year":"2001"},{"key":"b3","series-title":"Pediatr Neurosurg","first-page":"43","article-title":"Cerebral aspergillosis in children. Report of three cases.","volume":"33","author":"Cuccia","year":"2000"},{"key":"b4","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"297","article-title":"Two cases of cerebral aspergillosis successfully treated with voriconazole.","volume":"22","author":"de Lastours","year":"2003"},{"key":"b5","series-title":"Clin Infect Dis","first-page":"608","article-title":"Therapeutic outcome in invasive aspergillosis.","volume":"23","author":"Denning","year":"1996"},{"key":"b6","series-title":"Rev Infect Dis","first-page":"1147","article-title":"Antifungal and surgical treatment of invasive aspergillosis: review of 2,121 published cases.","volume":"12","author":"Denning","year":"1990"},{"key":"b7","series-title":"Br J Neurosurg","first-page":"137","article-title":"Intracavitary administration of amphotericin B in the treatment of cerebral aspergillosis in a nonimmune-compromised patient: case report and review of the literature.","volume":"14","author":"Elgamal","year":"2000"},{"key":"b8","series-title":"Sao Paulo Med J","first-page":"251","article-title":"Tumoral form of aspergillosis in central nervous system (cerebral aspergilloma): case report.","volume":"121","author":"Figueiredo","year":"2003"},{"key":"b9","series-title":"Neurosurgery","first-page":"96","article-title":"Stereotactic drainage of Aspergillus brain abscess with long-term survival: case report and review.","volume":"24","author":"Goodman","year":"1989"},{"key":"b10","series-title":"Eur Radiol","first-page":"377","article-title":"Invasive central nervous system aspergillosis in bone marrow transplantation recipients: an overview.","volume":"13","author":"Guermazi","year":"2003"},{"key":"b11","series-title":"Eur J Pediatr","first-page":"263","article-title":"Successful treatment of pulmonary and cerebral aspergillosis in an immunosuppressed child.","volume":"138","author":"Henze","year":"1982"},{"key":"b12","series-title":"N Engl J Med","first-page":"408","article-title":"Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis.","volume":"347","author":"Herbrecht","year":"2002"},{"key":"b13","series-title":"Mycoses","first-page":"123","article-title":"Successful treatment of cerebral aspergillosis by stereotactic operation and antifungal therapy.","volume":"37","author":"Kerkmann","year":"1994"},{"key":"b14","series-title":"J Pediatr Neurol","first-page":"39","article-title":"Clinicopathological and genetic study in cerebral aspergillosis and leukemic infiltration in ALL.","volume":"2","author":"Kumar","year":"2004"},{"key":"b15","series-title":"Transpl Infect Dis","first-page":"140","article-title":"Antigen detection in the diagnosis and management of a patient with probable cerebral aspergillosis treated with voriconazole.","volume":"2","author":"Machetti","year":"2000"},{"key":"b16","series-title":"Comput Med Imaging Graph","first-page":"489","article-title":"CT and MR findings of brain aspergillosis.","volume":"27","author":"Okafuji","year":"2003"},{"key":"b17","series-title":"Clin Infect Dis","first-page":"628","article-title":"Localization of aspergillosis to the central nervous system among patients with acute leukemia: report of 14 cases. Gruppo Italiano Malattie Ematologiche dell'Adulto Infection Program.","volume":"23","author":"Pagano","year":"1996"},{"key":"b18","series-title":"Br J Haematol","first-page":"663","article-title":"Successful treatment of cerebral aspergillosis with a novel triazole (voriconazole) in a patient with acute leukaemia.","volume":"97","author":"Schwartz","year":"1997"},{"key":"b19","series-title":"Ann Neurol","first-page":"574","article-title":"Aspergillosis of the central nervous system: clinicopathological analysis of 17 patients.","volume":"18","author":"Walsh","year":"1985"},{"key":"b1","series-title":"Neurology","first-page":"473","article-title":"Aspergillosis of the nervous system.","volume":"32","author":"Beal","year":"1982"},{"key":"b2","series-title":"Australas Radiol","first-page":"338","article-title":"Central nervous system aspergillus infection complicating renal transplantation.","volume":"45","author":"Coates","year":"2001"},{"key":"b3","series-title":"Pediatr Neurosurg","first-page":"43","article-title":"Cerebral aspergillosis in children. Report of three cases.","volume":"33","author":"Cuccia","year":"2000"},{"key":"b4","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"297","article-title":"Two cases of cerebral aspergillosis successfully treated with voriconazole.","volume":"22","author":"de Lastours","year":"2003"},{"key":"b5","series-title":"Clin Infect Dis","first-page":"608","article-title":"Therapeutic outcome in invasive aspergillosis.","volume":"23","author":"Denning","year":"1996"},{"key":"b6","series-title":"Rev Infect Dis","first-page":"1147","article-title":"Antifungal and surgical treatment of invasive aspergillosis: review of 2,121 published cases.","volume":"12","author":"Denning","year":"1990"},{"key":"b7","series-title":"Br J Neurosurg","first-page":"137","article-title":"Intracavitary administration of amphotericin B in the treatment of cerebral aspergillosis in a nonimmune-compromised patient: case report and review of the literature.","volume":"14","author":"Elgamal","year":"2000"},{"key":"b8","series-title":"Sao Paulo Med J","first-page":"251","article-title":"Tumoral form of aspergillosis in central nervous system (cerebral aspergilloma): case report.","volume":"121","author":"Figueiredo","year":"2003"},{"key":"b9","series-title":"Neurosurgery","first-page":"96","article-title":"Stereotactic drainage of Aspergillus brain abscess with long-term survival: case report and review.","volume":"24","author":"Goodman","year":"1989"},{"key":"b10","series-title":"Eur Radiol","first-page":"377","article-title":"Invasive central nervous system aspergillosis in bone marrow transplantation recipients: an overview.","volume":"13","author":"Guermazi","year":"2003"},{"key":"b11","series-title":"Eur J Pediatr","first-page":"263","article-title":"Successful treatment of pulmonary and cerebral aspergillosis in an immunosuppressed child.","volume":"138","author":"Henze","year":"1982"},{"key":"b12","series-title":"N Engl J Med","first-page":"408","article-title":"Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis.","volume":"347","author":"Herbrecht","year":"2002"},{"key":"b13","series-title":"Mycoses","first-page":"123","article-title":"Successful treatment of cerebral aspergillosis by stereotactic operation and antifungal therapy.","volume":"37","author":"Kerkmann","year":"1994"},{"key":"b14","series-title":"J Pediatr Neurol","first-page":"39","article-title":"Clinicopathological and genetic study in cerebral aspergillosis and leukemic infiltration in ALL.","volume":"2","author":"Kumar","year":"2004"},{"key":"b15","series-title":"Transpl Infect Dis","first-page":"140","article-title":"Antigen detection in the diagnosis and management of a patient with probable cerebral aspergillosis treated with voriconazole.","volume":"2","author":"Machetti","year":"2000"},{"key":"b16","series-title":"Comput Med Imaging Graph","first-page":"489","article-title":"CT and MR findings of brain aspergillosis.","volume":"27","author":"Okafuji","year":"2003"},{"key":"b17","series-title":"Clin Infect Dis","first-page":"628","article-title":"Localization of aspergillosis to the central nervous system among patients with acute leukemia: report of 14 cases. Gruppo Italiano Malattie Ematologiche dell'Adulto Infection Program.","volume":"23","author":"Pagano","year":"1996"},{"key":"b18","series-title":"Br J Haematol","first-page":"663","article-title":"Successful treatment of cerebral aspergillosis with a novel triazole (voriconazole) in a patient with acute leukaemia.","volume":"97","author":"Schwartz","year":"1997"},{"key":"b19","series-title":"Ann Neurol","first-page":"574","article-title":"Aspergillosis of the central nervous system: clinicopathological analysis of 17 patients.","volume":"18","author":"Walsh","year":"1985"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/103\/4\/article-p374.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/103\/4\/article-p374.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/103\/4\/article-p374.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T10:19:45Z","timestamp":1782209985000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/103\/4\/article-p374.xml"}},"subtitle":["Report of four cases"],"short-title":[],"issued":{"date-parts":[[2005,10]]},"references-count":38,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/ped.2005.103.4.0374","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[2005,10]]}}}