Cerebral aspergillosis: a retrospective analysis of eight cases
Autor: | Xusheng Huang, Wei-quan Jia, Ruo-Xi Wang, Yu Chen, Jia-tang Zhang, Shengyuan Yu |
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Rok vydání: | 2016 |
Předmět: |
Adult
Male medicine.medical_specialty Pediatrics Antifungal Agents medicine.drug_class Central nervous system Antibiotics Antifungal drug Aspergillosis Young Adult 03 medical and health sciences 0302 clinical medicine Cerebral aspergillosis Humans Medicine 030212 general & internal medicine Young adult Intensive care medicine Retrospective Studies Cerebral Cortex business.industry General Neuroscience Incidence (epidemiology) Retrospective cohort study General Medicine Middle Aged medicine.disease medicine.anatomical_structure Female business 030217 neurology & neurosurgery |
Zdroj: | International Journal of Neuroscience. 127:339-343 |
ISSN: | 1543-5245 0020-7454 |
Popis: | Aspergillosis of the central nervous system is very rare. However with recent increases in the use of immunosuppressive agents and antibiotics, its incidence is increasing. We evaluated the demographics, clinical manifestations, laboratory findings, diagnosis, underlying conditions, treatment regimens and outcomes of patients with cerebral aspergillosis (CA).We retrospectively reviewed data from eight patients with CA hospitalized at a Chinese general hospital from 1 January 2005 to 30 September 2015.Common clinical manifestations included headache and cranial nerve involvement. Four patients underwent biopsy and were pathologically diagnosed with Aspergillus hyphae. One patient was proved to have Aspergillus infection via autopsy. One patient had positive cerebrospinal fluid fungal cultures. The lesion locations were: the cavernous sinus (n = 5, 62.5%), frontal lobe (n = 1, 12.5%), temporosphenoid lobe (n = 1, 12.5%) and cerebellum (n = 1, 12.5%). At the end of follow-up, three patients were cured and five patients had died (mortality rate, 62.5%).Most patients with CA had no significant immunosuppression-related conditions in our study. Aspergillus spp. can infect the central nervous system through several pathways and CA has an atypical clinical manifestation. The use of local tissue puncture, surgery or other invasive means to obtain diseased tissue containing higher levels of Aspergillus, followed by culture or histological examination, can contribute to an early diagnosis of CA and timely therapeutic intervention. The prognosis of CA is poor, but early and adequate use of antifungal drugs with high transfer across the blood-brain barrier and radical surgery to remove lesions can improve the survival rate. |
Databáze: | OpenAIRE |
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