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Background: The incidence of invasive aspergillosis has increased worldwide. Information regarding the clinical characteristics of patients with extrapulmonary involvement is scarce., Objective: We aimed to describe the pathogenesis, characteristics and outcomes of patients with invasive aspergillosis and extrapulmonary disease., Methods: A retrospective study conducted in a university hospital in Barcelona, Spain (1995-2011)., Results: A total of 12 cases of invasive aspergillosis and extrapulmonary involvement were found. The most common clinical manifestations were invasive sinusitis, early postoperative prosthetic valve endocarditis, fungaemia, postoperative meningitis, multiple brain abscesses and lumbar spondylitis with epidural abscess. Sinusitis occurred frequently in patients without immunosuppression and had invasive brain involvement in one case. Endocarditis was associated with multiple septic metastases. Concomitant lung involvement was documented in 5 cases. The strains isolated were Aspergillus fumigatus (5), Aspergillus flavus (3), and Aspergillus niger (2). The species of Aspergillus was not established for 3 isolates. All patients were treated with antifungals and surgery was performed in 8 cases. Outcome was related with the source of infection; all patients with invasive sinusitis survived, while the remaining patients had a high mortality rate (88%)., Conclusions: Invasive aspergillosis with extrapulmonary involvement is rare. The most common presentation is invasive sinusitis, which has a lower mortality. Other clinical forms with extrapulmonary involvement were associated with severe immunosuppression or previous surgery, and had a poor outcome., (Copyright © 2011 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.)

Aim: Brain abscesses continue to pose a problem in paediatric neurosurgery because the associated morbidity and mortality have remained significant throughout the antibiotic and CT era. The objective of this paper is to report the treatment of 28 children with the diagnosis of brain abscess., Methods: We report our experience with the surgical management of brain abscesses in 28 paediatric patients between 1981 and 2005. The following parameters were assessed: age, gender, clinical manifestations, physical examination, radiological data, aetiological agent, treatment and clinical evolution of the patients., Results: Patients' age varied from 2 weeks to 16 years (mean 8.6 years); 17 were male. The most notable predisposing factor was contiguous infection in 11 cases, of which six were chronic otitis media. The abscess was supratentorial in 27 children with only one infratentorial case. In all patients, treatment consisted of a combination of surgical evacuation and antibiotics. In two children, the evacuation of pus was via transfontanelar puncture. Positive abscess cultures were obtained from 15 abscesses, and gram-negative were the main bacteria involved. Nine patients had neurological sequelae (seizure, cognitive impairment and paresis); two deaths occurred., Conclusions: Brain abscess in children continues to be associated with high rates of neurological impairment and death.