Double Vision and Gait Ataxia in an Immunocompetent 9-Year-Old Girl With Intracranial Phaeohyphomycosis

Update Item Information
Title Double Vision and Gait Ataxia in an Immunocompetent 9-Year-Old Girl With Intracranial Phaeohyphomycosis
Creator Aishwarya V. Pareek; Timothy E. Lotze; Gail Demmler; Carrie A. Mohila; Brandon Tran; Veeral S. Shah
Affiliation Department of Pediatrics, Divisions of Neurology and Developmental Neuroscience (AVP, TEL), Infectious Disease (GD), Pathology (CAM), and Radiology (BT), Baylor College of Medicine, Texas Children's Hospital, Houston, Texas; and Department of Ophthalmology and Neurology (VSS), Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio
Abstract A 9-year-old girl presented with morning headaches associated with vomiting, gait ataxia, and facial and ocular motor nerve palsies. Her initial imaging was concerning for demyelinating disease. After extensive infectious and rheumatologic workup returned negative, she was treated twice with intravenous immunoglobulin and intravenous steroids with near-complete resolution each time. She returned, however, with worsening neurologic deficits and imaging revealing focal ischemic infarction in the brainstem as well as new-onset hydrocephalus. A multispecialty workup was initiated without conclusive diagnosis. A novel, noninvasive test for plasma cell-free DNA established a diagnosis of Cladophialophora bantiana that was confirmed and validated by a brain biopsy taken during a clinical decompensation. Treatment was initiated with systemic voriconazole and intraventricular amphotericin B.
Subject Ascomycota; Biopsy; Brain Abscess; Differential Diagnosis; Diplopia; Gait Ataxia; Immunocompromised Host; Phaeohyphomycosis
OCR Text Show
Date 2021-09
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Source Journal of Neuro-Ophthalmology, September 2021, Volume 41, Issue 3
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s6kefx99
Setname ehsl_novel_jno
ID 2033175
Reference URL https://collections.lib.utah.edu/ark:/87278/s6kefx99
Back to Search Results