Successful treatment of severe kerion Celsi in an immunocompromised girl with evacuation of pus, terbinafine and short course glucocorticosteroids

Publication date: March 2016
Source:Journal de Mycologie Médicale / Journal of Medical Mycology, Volume 26, Issue 1

Author(s): Z.H. Liu, Y. Zhang, J. Zhu, Y.Q. Dai, H. Shen

A 6-year-old girl with a 2-year history of idiopathic thrombocytopenic purpura complained of a 4-week history of scalp desquamation together with small pustules. During the recent 10 days, she complained of high fever with multiple abscesses formation with no response to intravenous antibiotics. She received varied doses of oral prednisone therapy for 2years. Microscopy showed endothrix infection. We prescribed terbinafine 125mg/d and prednisone 10mg/d. After 1week, she returned to our office with severe ache and persistent high fever. She refused any topical drugs because of pain. Manual pressure to remove pus from sinuses and infected scale under general anesthesia was done and about 100ml pus was discharged from kerion lesions. Prednisone (1mg/kg/d) was started and fever disappeared on the same day. Prednisone was tapered to withdraw in 10 days. A total of a 3-month course of oral terbinafine (125mg/d) resulted in mycological clearance. Hair regrowth was satisfactory 8months later.

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