A rare case report of cerebral phaeohyphomycosis mimicking glioma in a patient of rheumatic valvular heart disease

Autor: Ashish Chugh, Sharada Rane, Charandeep Singh Gandhoke, Kulkarni Maithili
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Zdroj: Indian Journal of Neurosurgery, Vol 02, Iss 02, Pp 199-202 (2013)
Druh dokumentu: article
ISSN: 2277-954X
2277-9167
DOI: 10.4103/2277-9167.118130
Popis: Phaeohyphomycosis is a collective term used for fungal infections caused by moulds and yeasts that have brown pigmented cell walls due to the presence of melanin. These are also known as dematiaceous fungi. We report this patient who presented with headache, right hemiparesis, slurred speech, and altered sensorium. Patient was a known case of rheumatic valvular heart disease (RVHD) and had undergone balloon valvotomy for mitral stenosis 1 year back. Radiological features were suggestive of high grade glioma. Left fronto-parietal decompressive craniectomy with complete excision of mass lesion was performed. Histopathological examination of the surgical specimen revealed multiple granulomas with giant cells. These giant cells contained branched septate pigmented fungal hyphae in their cytoplasm. After the histopathology report, patient was started on intravenous amphotericin and was discharged on oral itraconazole 200 mg twice daily. Unfortunately, the patient was non-compliant and stopped taking oral itraconazole after 1 month. He landed up in fulminant fungal meningo-encephalitis and died 10 weeks after the initial diagnosis. We report a rare case of cerebral phaeohyphomycosis in a patient of RVHD which, to our knowledge, is nowhere mentioned in the literature.
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