1/3. pulmonary aspergillosis with possible cerebral involvement in a previously healthy pregnant woman.Invasive aspergillosis is observed mainly in immunodepressed patients. Here we report a case of pulmonary aspergillosis with CNS involvement in a pregnant woman without other known causes of immunodeficiency. Case report: A 23-years old pregnant woman underwent a caesarean because of unexplained seizures. During the subsequent days worsening headache and a deteriorating neurological status were reported suggesting meningitis. Stiffness, right sided hemiparesis and cranial nerve palsies were observed at admission. Radiological findings revealed lesions involving the right pulmonary apex, the right cerebellar hemisphere and the Pterygopalatina fossa. Microbiological studies revealed large colonies of aspergillus fumigatus. A favorable outcome was observed after administration of liposomal amphotericin b and 5-fluorocytosine and, at improved conditions, when oral uptake of itraconazole was given. The authors conclude that risk of infections sustained by fungal opportunistic agents during pregnancy must be considered. Sequential antifungal administration may be an efficient therapy able to shorten hospitalization.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
2/3. Cerebral aspergillosis due to aspergillus fumigatus in AIDS patient: first culture-proven case reported in brazil.Cerebral aspergillosis is a rare cause of brain expansive lesion in AIDS patients. We report the first culture-proven case of brain abscess due to aspergillus fumigatus in a Brazilian AIDS patient. The patient, a 26 year-old male with human immunodeficiency virus (hiv) infection and history of pulmonary tuberculosis and cerebral toxoplasmosis, had fever, cough, dyspnea, and two episodes of seizures. The brain computerized tomography (CT) showed a bi-parietal and parasagittal hypodense lesion with peripheral enhancement, and significant mass effect. There was started anti-toxoplasma treatment. Three weeks later, the patient presented mental confusion, and a new brain CT evidenced increase in the lesion. He underwent brain biopsy, draining 10 mL of purulent material. The direct mycological examination revealed septated and hyaline hyphae. There was started amphotericin b deoxycholate. The culture of the material demonstrated presence of the aspergillus fumigatus. The following two months, the patient was submitted to three surgeries, with insertion of drainage catheter and administration of amphotericin b intralesional. Three months after hospital admission, his neurological condition suffered discrete changes. However, he died due to intrahospital pneumonia. brain abscess caused by aspergillus fumigatus must be considered in the differential diagnosis of the brain expansive lesions in AIDS patients in brazil.- - - - - - - - - - ranking = 0.5keywords = administration (Clic here for more details about this article) |
3/3. Cerebellar aspergillosis in an infant: case report.OBJECTIVE AND IMPORTANCE: Intracranial aspergillosis is occasionally seen among immunocompromised patients, the incidence increasing in consequence to large-scale use of chemotherapy against malignancies and immunosuppression after organ transplantation. Immunocompetent patients harboring invasive intracranial fungal infections still remain an elusive diagnosis. CLINICAL PRESENTATION: A 7-month-old immunocompetent infant who developed and harbored cerebellar aspergillosis until 3 years of age is reported. INTERVENTION: Radical surgical resection of posterior fossa mass (aspergilloma) and parenteral administration of amphotericin b led to a successful outcome. CONCLUSION: The differential diagnosis at both stages of presentation and the possible mode of infection are discussed according to the radiological images. Preoperative diagnosis on the basis of imaging is difficult. The pathogenesis of such an infection remains uncertain. Parenteral amphotericin b, followed by prolonged itraconazole therapy, remains the "gold standard" modality for central nervous system fungal infections in adjunct to aggressive surgical debridement.- - - - - - - - - - ranking = 0.5keywords = administration (Clic here for more details about this article) |