1/28. Multiple infarcts in a patient with cerebral phaeohyphomycosis: CT and MRI.Phaeohyphomycosis is an uncommon disorder caused by a variety of saprophytic fungi having distinctive morphologic features. central nervous system infection typically occurs in the absence of predisposing factors and usually manifest symptoms and signs of abscess formation. We describe an otherwise healthy young man whose presentation with cerebral phaeohyphomycosis was subacute meningitis and stroke. neuroimaging studies revealed multiple parenchymal lesions having the characteristics of recent infarcts; several vascular territories were involved. The nature of these lesions was confirmed histologically at autopsy. To our knowledge, such radiologic appearances have not previously been reported in this condition.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/28. central nervous system aspergillosis in patients with human immunodeficiency virus infection. Report of 6 cases and review.central nervous system (CNS) aspergillosis is a relatively uncommon complication of human immunodeficiency virus (hiv) infection. We describe 6 patients with the acquired immunodeficiency syndrome (AIDS) who developed CNS aspergillosis, and we review a total of 33 cases of CNS aspergillosis among hiv-infected individuals that were diagnosed by histology and/or culture. All patients were diagnosed with advanced hiv infection. Major risk factors for the disease included neutropenia and corticosteroid use. The most common presenting symptoms were nonspecific neurologic manifestations including headache, cranial or somatic nerve weakness or paresthesia, altered mental status, and seizures. The most common sites of additional aspergillus involvement were the lungs, sinuses, ears, and orbits, while in one-fourth of the cases CNS was the only site of aspergillus infection. The final diagnosis of CNS aspergillosis was made on autopsy in more than half the cases, and medical treatment of CNS aspergillosis was unsuccessful in all cases. CNS aspergillosis should be included in the differential diagnosis of hiv-infected patients who present with nonspecific neurologic symptoms and signs. If we take into account the much higher prevalence of invasive aspergillosis of the lungs, the findings in the present report suggest that CNS aspergillosis in hiv-infected individuals occurs more often as a result of direct extension from the sinuses, orbits, and ears than through hematogenous spread from the lungs. physicians should be aware that the CNS might be the only site of aspergillus involvement and include CNS aspergillosis in the differential diagnosis of hiv-infected patients presenting with focal neurologic signs and symptoms, especially when the head CT reveals hypodense lesions.- - - - - - - - - - ranking = 7keywords = infection (Clic here for more details about this article) |
3/28. Cerebral cryptococcosis: atypical appearances on CT.Cryptococcal infection is common in immunocompromised patients, often presenting with meningitis or meningoencephalitis. We report an unusual presentation of cryptococcal infection in an immunocompetent patient presenting with headache and hemiplegia. CT demonstrated a large ring-enhancing lesion in the parietal region with intralesional calcification.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
4/28. Isolation of a Nodulisporium species from a case of cerebral phaeohyphomycosis.A fungal infection of the brain of a 55-year-old male patient is reported. The lesion and involved fungus were located exclusively in the right medial temporo-parietal region. The patient was successfully treated with surgical resection of the lesion and antifungal chemotherapy. Few pathogenic dematiaceous fungi exhibit neurotropism and can cause primary infection in the central nervous system (CNS). The etiological agent is described as a Nodulisporium species. To date Nodulisporium has never been reported as an agent of CNS infection in humans.- - - - - - - - - - ranking = 3keywords = infection (Clic here for more details about this article) |
5/28. Disseminated Cladophialophora bantiana infection in a heart transplant recipient.cerebral phaeohyphomycosis caused by Cladophialophora bantiana, a dematiaceous fungus, is a rare disease. The majority of cases have been reported among immunocompetent patients; only 4 cases have been published that describe transplantation patients. The overall prognosis is poor. Surgical therapy in combination with chemotherapy with itraconazole is recommended. We report the case of a heart transplant recipient with cutaneous, cerebral, and lung manifestation of Cladophialophora bantiana who died despite surgical and systemic, high-dosage itraconazole treatment.- - - - - - - - - - ranking = 4keywords = infection (Clic here for more details about this article) |
6/28. Mycotic aneurysms as lethal complication of brain pseudallescheriasis in a near-drowned child: a CT demonstration.Intracranial true mycotic aneurysms are rare and generally lethal. We report a case of a near-drowned child with brain abscesses due to pseudallescheria boydii, a saprophytic fungus, who died after subarachnoid hemorrhage occurred. CT showed contrast-enhancing lesions indicative of aneurysms of basilar and right posterior cerebral arteries that could not be appreciated 2 days before. P. boydii is often resistant to commonly used antimycotic drugs. Because CNS infection is frequently associated with near-drowning, early diagnosis and specific therapy are strongly recommended for these patients.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
7/28. Phaeohyphomycosis of the central nervous system in immunocompetent hosts: report of a case and review of the literature.Background: Phaeohyphomycosis refers to infections caused by phaeoid fungi that can have an aggressive course in normal hosts. Involvement of the central nervous system may occur with a generally poor outcome. Clinical report and literature review: We report a case of Bipolaris sp. brain abscess in an immunologically competent host. We also review all previous cases of cerebral phaeohyphomycosis in normal hosts reported in the literature to date. Conclusions: Central nervous system phaeohyphomycosis remains an unusual disease; however, its incidence has been increasing in recent years. The prognosis of this condition is still poor, despite medical and surgical interventions. Aggressive diagnostic approaches and careful interpretation of cultures might modify the natural history of this disease.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
8/28. Improving outcomes in rhinocerebral mucormycosis--early diagnostic pointers and prognostic factors.Rhinocerebral mucormycosis is an uncommon, rapidly progressive, highly fatal sinus infection, usually occurring in immunocompromised hosts. We describe our clinical experience with nine such consecutive cases managed at our centre, with emphasis on identifying early diagnostic and prognostic features. Perinasal cellulitis/paraesthesia was the most frequent early clinical sign of disease, being evident in at least six cases. Periorbital oedema, mucopurulent rhinorrhoea and nasal crusting were the other early manifestations. Concurrent computed tomography (CT) scan at this initial stage however revealed only minimal mucosal thickening of the sinuses in all four cases wherein it was done. Intracranial extension as evident on CT was the only adverse prognostic sign (p<0.05). The present report highlights the importance of early diagnosis and prompt institution of antifungal chemotherapy in ensuring a favourable outcome in rhinocerebral mucormycosis. However, initial CT is frequently near-normal and biopsy time-consuming and often not feasible. To optimize early diagnosis therefore, the clinician should be highly alert to certain subtle clinical signs, in the appropriate setting of an immunocompromised patient.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
9/28. Unsuccessful treatment with voriconazole of a brain abscess due to Cladophialophora bantiana.Cladophialophora bantiana is a dematiaceous fungus, associated with brain abscess in normal or immunosuppressed patients. We report a case of CNS infection in this agent unsuccessfully treated by surgery and various antifungal compounds including high doses of voriconazole (6 mg/kg bid). No adverse effects related to this compound were observed.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
10/28. Tumoral form of aspergillosis in central nervous system (cerebral aspergilloma): case report.aspergillosis of the central nervous system is an uncommon infection, mainly occurring in immunocompromised patients. It may be presented in several forms: meningitis, mycotic aneurysms, infarcts and the tumoral form (aspergilloma). The authors report a case of a diabetic patient with cerebral aspergilloma.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
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