1/125. early diagnosis of central nervous system aspergillosis with combination use of cerebral diffusion-weighted echo-planar magnetic resonance image and polymerase chain reaction of cerebrospinal fluid.We treated a patient diagnosed as central nervous system (CNS) aspergillosis with the combined use of cerebral diffusion-weighted echo-planar magnetic resonance imaging (DWI) and polymerase chain reaction of the cerebrospinal fluid (CSF-PCR). DWI, a cutting-edge imaging modality to reveal the earliest changes of cerebral infarction, detected cerebral fungal embolization when the conventional computed tomographic scan and magnetic resonance imaging failed to reveal it. CSF-PCR demonstrated the presence of Aspergillus-specific dna in the specimen, when the conventional examination and culture of CSF were nonspecific or negative. These diagnostic methods could be useful in the early diagnosis of CNS aspergillosis.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
2/125. Value of Ga-67 SPECT in monitoring the effects of therapy in invasive aspergillosis of the sphenoid sinus.PURPOSE: We report a case of invasive sphenoid sinus aspergillosis clinically presenting as a pituitary mass. methods: After exploration via the trans-sphenoidal approach and subsequent treatment with amphotericin-B, Ga-67 brain SPECT was performed twice to monitor the therapeutic effect. RESULTS: Three months after antifungal treatment, Ga-67 brain SPECT showed partial resolution of the lesion in the sella turcica region. The patient continued with fluconazole treatment for another 2 months and received another Ga-67 brain SPECT, which showed complete clearing of the previous lesion. CONCLUSION: Ga-67 brain SPECT may play a potentially useful role in monitoring the therapeutic effect of treatment of invasive sphenoid sinus aspergillosis.- - - - - - - - - - ranking = 0.065189004867815keywords = brain (Clic here for more details about this article) |
3/125. Aspergillus osteoarthritis in acute lymphoblastic leukemia.We report an unusual case of arthritis of the right wrist due to aspergillus fumigatus without evidence for a generalized infection, following chemotherapy for acute lymphoblastic leukemia. The diagnosis was made by surgical biopsy. Amphotericin-B (Am-B) was not tolerated by the patient. Liposomal preparations of Am-B penetrate poorly into bone and cartilage. Therefore, oral itraconazole was given; the arthritis improved and chemotherapy was continued without infectious complications. Two weeks after complete hematopoietic recovery, an intracranial hemorrhage from a mycotic aneurysm of a brain vessel occurred, although the patient was still receiving itraconazole. We emphasize the importance of prompt and thorough efforts to identify the causative agent in immunocompromised patients with a joint infection. itraconazole is effective in Aspergillus osteoarthritis but, due to its poor penetration into the brain, the combination with a liposomal formulation of Am-B is recommended.- - - - - - - - - - ranking = 0.032594502433908keywords = brain (Clic here for more details about this article) |
4/125. Case report. Mixed systemic mycosis with fatal outcome in a patient with acute myeloblastic leukaemia.Fungal infections represent an increasing problem in immunocompromised patients. The majority of cases are caused by one single fungal pathogen and infections with more than one fungus are very rare. Here we describe a case of combined infection with Aspergillus and a zygomycete species, involving the lungs, spleen and the brain and leading to fatal outcome in spite of early antimycotic therapy.- - - - - - - - - - ranking = 0.016297251216954keywords = brain (Clic here for more details about this article) |
5/125. Intracavitary administration of amphotericin b in the treatment of cerebral aspergillosis in a non immune-compromised patient: case report and review of the literature.A 24-year-old man presented with cerebral aspergillus fungal granuloma involving the left frontal region secondary to pulmonary aspergillosis. He was otherwise healthy with no evidence of immune-suppression. Because of poor penetration of amphotericin b into the brain and cerebrospinal fluid (CSF), this patient was treated by a combination of systemic and local therapy in addition to surgical excision resulting in a cure with follow up for more than three years. This form of treatment produced no untoward long-term side effects or neurological sequel. On review of the literature on aspergillosis of the central nervous system (CNS), we found that six patients, including the present case, have been reported who survived longer than 1 year; their treatment included local administration of antifungal agent in the abscess cavity or into cerebral ventricles in order to control this devastating, treatment-resistant pathological fungal infection.- - - - - - - - - - ranking = 0.21629725121695keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
6/125. 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 = 0.2411465079093keywords = nervous system (Clic here for more details about this article) |
7/125. Successful treatment of aspergillus brain abscess in a child with acute lymphoblastic leukemia.Cerebral aspergillosis carries a high mortality in immunocompromised patients. However, favorable outcome can be achieved by the prolonged use of antifungal agents and the maintenance of adequate drug levels. The authors report a 2-year-old girl who developed an aspergillus brain abscess during treatment for acute lymphoblastic leukemia. Predisposing factors for the fungal infection and details of the antifungal therapy are described. Prolonged treatment with AmBisome and 5-flucytosine successfully eradicated the lesion, but the girl's antileukemic therapy was compromised due to the infection. She developed a central nervous system and bone marrow relapse 9 and 15 months, respectively, after the initial presentation. The report emphasizes the need for further consideration of effective, long-term antifungal prophylaxis and a careful balance between aggressive treatment for severe infection and antileukemic therapy.- - - - - - - - - - ranking = 0.28148625608477keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
8/125. Disseminated aspergillosis in a renal transplant patient: Diagnostic difficulties re-emphasized.An asymptomatic and radiographically occult lung abscess was the primary focus of infection in this case of fatal disseminated aspergillosis in a renal transplant recipient. Extensive neurological evaluation in response to a change in personality failed to reveal a brain abscess, which was the cause of death. This case illustrates the variability in presentations of aspergillosis and the continuing difficulties in diagnosing this infection in immunosuppressed patients.- - - - - - - - - - ranking = 0.016297251216954keywords = brain (Clic here for more details about this article) |
9/125. Successful non-surgical treatment of disseminated polymicrobial fungal infection in a patient with pancytopenia and graft-versus-host disease.Invasive fungal infections after bone marrow transplantation have an extremely poor prognosis. Surgical excision in combination with antifungal therapy is considered necessary for treatment, especially for central nervous system (CNS) infection. We describe successful medical management with lipid complex amphotericin b (ABLC) and itraconazole, without surgical excision, of disseminated fungal infection involving the lungs and CNS in a patient with pancytopenia and graft-versus-host disease.- - - - - - - - - - ranking = 0.2keywords = central nervous system, nervous system (Clic here for more details about this article) |
10/125. Successful treatment of aspergillus brain abscess with itraconazole and interferon-gamma in a patient with chronic granulomatous disease.This report describes the successful treatment of Aspergillus brain abscess in a boy with chronic granulomatous disease.- - - - - - - - - - ranking = 0.081486256084769keywords = brain (Clic here for more details about this article) |
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