Neuroaspergillosis in an immunocompetent patient successfully treated with voriconazole and a corticosteroid
| Autor: | Tsutomu Numata, Shigeko Sunami, Ikuo Kamitsukasa, Akiyuki Uzawa, Akiyuki Hiraga, Mariko Shibuya |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Male
Pathology medicine.medical_specialty Antifungal Agents medicine.drug_class Central nervous system Inflammation Aspergillosis Internal Medicine medicine Humans Aged Voriconazole Neuroaspergillosis Brain Diseases medicine.diagnostic_test business.industry Remission Induction Magnetic resonance imaging General Medicine Triazoles medicine.disease Discontinuation medicine.anatomical_structure Pyrimidines Immunology Corticosteroid Brainstem medicine.symptom business Immunocompetence medicine.drug |
| Zdroj: | Internal medicine (Tokyo, Japan). 48(14) |
| ISSN: | 1349-7235 |
| Popis: | Aspergillosis of the central nervous system (CNS) is an uncommon infection, mainly occurring in immunocompromised patients. We report a case of nasocerebral aspergillosis in an immunocompetent patient successfully treated with voriconazole and a corticosteroid. Magnetic resonance imaging (MRI) showed contrast enhancement surrounding the brainstem and cerebellum with intramedullary pontine and cerebellar T2-hyperintense lesions. The patient's symptoms and MRI abnormalities improved after voriconazole and corticosteroid treatment; however, discontinuation of the corticosteroid caused a worsening of the T2-hyperintense lesions, whereas resuming it resulted in its improvement. This suggested that these T2-hyperintense lesions may be due to secondary inflammation caused by aspergillosis and not the aspergillosis itself. We conclude that treatment with a combination of voriconazole and a corticosteroid appears to be effective for the treatment of some patients with CNS aspergillosis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|