Central nervous system blastomycosis clinical characteristics and outcomes
| Autor: | Keaton Kaye, Kathryn Majdick, Mahmoud Shorman |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Azoles Male medicine.medical_specialty Antifungal Agents Late Diagnoses Central nervous system Blastomycosis Cohort Studies 03 medical and health sciences 0302 clinical medicine Central Nervous System Fungal Infections Disease severity medicine Humans 030212 general & internal medicine Voriconazole 0303 health sciences medicine.diagnostic_test biology 030306 microbiology Blastomyces dermatitidis business.industry Magnetic resonance imaging General Medicine Middle Aged Triazoles biology.organism_classification medicine.disease Tennessee Dermatology Treatment Outcome Infectious Diseases medicine.anatomical_structure Cohort Blastomyces Female business medicine.drug |
| Zdroj: | Medical Mycology. 59:87-92 |
| ISSN: | 1460-2709 1369-3786 |
| DOI: | 10.1093/mmy/myaa041 |
| Popis: | Blastomycosis is a local or systemic infection, caused by Blastomyces dermatitidis (B. dermatitidis) or B. gilchristii. Blastomycosis has been described as “the great pretender,” alluding to the fact that it manifests in a wide range of symptoms and disease severity. Central nervous system (CNS) involvement, although rare, carries significant mortality. Due to the limited published reports of CNS blastomycosis, we present an updated cohort with eight cases of proven or probable CNS blastomycosis describing presentation, diagnosis, treatment and outcomes. Headache was the most common presenting symptom. Magnetic resonance imaging (MRI) proved to be the superior imaging study. All patients in our cohort were diagnosed by histopathological staining or cultures of tissue or fluid obtained from CNS or extra-CNS lesions. All patients that received treatment with Liposomal amphrotericin B for at least 10 days followed by a prolonged azole therapy did not have relapse. Two patients with late diagnoses died during hospitalization. Our findings confirm the importance of timely diagnosis and treatment of CNS blastomycosis to improve outcomes especially with an azole that have a high CNS penetration and a good intrinsic activity for B. dermatitidis such as voriconazole. |
| Databáze: | OpenAIRE |
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