Lackner Herwig, Sovinz Petra, Benesch Martin, Smolle-Jüttner Freyja, Mokry Michael, Schwinger Wolfgang, Moser Andrea, Urban Christian
Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology, Medical University of Graz, Graz, Austria.
Pediatr Blood Cancer. 2009 Mar;52(3):408-11. doi: 10.1002/pbc.21814.
Brain abscesses in children with leukemia or other malignancies are rare and potentially fatal. We report on four children who developed brain abscesses during treatment for acute lymphoblastic leukemia (ALL). All patients received multimodal broad-spectrum antibiotic therapy and liposomal amphotericin-B in combination with hyperbaric oxygen. First-line antimicrobial treatment was modified when a causative organism was isolated. All four patients survived, with two patients showing complete resolution of neurological and MRI abnormalities and with two patients still having residual lesions. To date, all patients are in remission with three patients still receiving antileukemic therapy. Brain abscesses can be successfully managed by a multimodality approach even in severely immunocompromised cancer patients.
患有白血病或其他恶性肿瘤的儿童发生脑脓肿较为罕见且可能致命。我们报告了4例在急性淋巴细胞白血病（ALL）治疗期间发生脑脓肿的儿童。所有患者均接受了多模式广谱抗生素治疗以及脂质体两性霉素B联合高压氧治疗。分离出致病微生物后调整了一线抗菌治疗方案。所有4例患者均存活，其中2例患者的神经功能异常和MRI异常完全消失，2例患者仍有残留病灶。迄今为止，所有患者均处于缓解期，3例患者仍在接受抗白血病治疗。即使是严重免疫功能低下的癌症患者，脑脓肿也可通过多模式方法成功治疗。
