Cladophialophora bantiana brain abscess after pediatric liver transplant: A report of a long-term survivor

Abstract

We report long-term survival in a child who developed Cladophialophora bantiana brain abscess after liver transplantation with prolonged antifungal medications. A 6-year-old boy developed a left frontal abscess 1 month after orthotopic liver transplantation. Computed tomography-guided stereotactic aspiration was done which grew C. bantiana. The child was started on voriconazole and amphotericin B. Two months later, he underwent left frontal craniotomy with debridement for increase in intracranial lesions. Amphotericin B was administered for 3 weeks. He was discharged on oral posaconazole. On stopping posaconazole after 6 months, the child developed convulsions. Hence, it was restarted. Posaconazole was continued for 6 years and stopped. He is 11 years post liver transplant doing well. C. bantiana brain abscess in a child after liver transplant is very rare and is associated with high mortality. Improved survival mandates surgical evacuation of abscess and prolonged antifungal therapy.