Multiple cerebral abscesses caused by Aspergillus fumigatus following extracorporeal membrane oxygenation in a pediatric patient: A case report

Background: Invasive cerebral aspergillosis is a rare but serious condition with a high mortality rate. Case Description: We report a case of multiple brain abscesses with ventriculitis caused by Aspergillus fumigatus in an 11-year-old Thai boy who presented with a high-grade fever and progressive headache for 9 days during hospitalization. He was diagnosed with severe acute respiratory distress syndrome and secondary hemophagocytic lymphohistiocytosis. Treatment included veno-arterial-venous extracorporeal membrane oxygenation, broad-spectrum antibiotics, and prolonged corticosteroid therapy. He subsequently developed severe headaches due to increased intracranial pressure and brain edema, which were successfully managed with a combination of antifungal therapy and extensive neurosurgery. Conclusion: Early diagnosis and combined antifungal therapy, in combination with neurosurgery, are crucial for improving survival outcomes in invasive cerebral aspergillosis.