• Dongmei Meng, Yingxue Zou, Jiao Li, Jia Zhai, Run Guo, and Xingnan Jin.
• Department of Pneumology, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin, China.
• Medicine (Baltimore). 2024 Feb 9; 103 (6): e37160e37160.

RationaleChildren with haematological malignancies have a higher risk of developing aggressive pulmonary aspergillosis and a higher mortality rate. The most common site of extrapulmonary aspergillosis in children is the central nervous system (CNS), and the death rate is higher when CNS is affected. Therefore, early diagnosis and treatment of invasive aspergillosis are essential for reducing mortality.Patient ConcernsWe report a case of an 8-year-old girl with acute lymphoblastic leukaemia who developed invasive pulmonary aspergillosis complicated by CNS aspergillosis. Aspergillus was confirmed by metagenomic sequencing of pathogenic microorganisms.DiagnosesInvasive pulmonary and central nervous system aspergillosis.InterventionsThe patient was treated with combined systemic antifungal agents (voriconazole and liposomal amphotericin B) and intrathecal injection of amphotericin B.OutcomesThe treatment was well tolerated and resulted in remarkable clinical and radiological head improvements.LessonsInvasive aspergillosis has a high mortality rate and requires early diagnosis and treatment. Pathogenic microbial metagenomic sequencing is a convenient method to assist in the early diagnosis of aspergillosis. Voriconazole is the drug of choice for the treatment of invasive aspergillosis. When CNS aspergillosis occurs, it can be combined with other systemic antifungal drugs and intrathecal injection of amphotericin B.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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