1/26. meningoencephalitis due to blastomyces dermatitidis: case report and literature review.infection of the central nervous system by blastomyces dermatitidis is a rare cause of meningoencephalitis. The existence of exclusive clinical infection of the meninges in the absence of pulmonary or other foci of infection has been debated. We describe a 20-year-old man presenting with meningoencephalitis caused by B dermatitidis. Blastomycotic infection was confirmed by isolation of the organism from brain tissue obtained at biopsy. magnetic resonance imaging demonstrated progressive enhancement of basal meninges with involvement of bilateral basal ganglia and thalami. Treatment with amphotericin b arrested further neurologic decline. However, clinical and radiographic follow-up suggested damage to diencephalic structures. The diagnosis of blastomycotic meningoencephalitis is difficult to establish because no sensitive serologic test exists, and attempts to isolate the organism in cerebrospinal fluid obtained by lumbar puncture generally fail. A biopsy specimen of brain tissue is frequently necessary for the diagnosis. survival is possible with timely initiation of therapy.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
2/26. Recurrent blastomycosis of the central nervous system: case report and review.Although blastomycosis of the central nervous system (CNS) occurs in approximately 4% of patients with blastomycosis, recurrent CNS blastomycosis is very rare. We review the clinical features, treatment, and outcome of 4 previously reported cases. We also report a case of recurrent CNS blastomycosis successfully treated with surgery and liposomal amphotericin b after an inadequate response to amphotericin b therapy. This treatment may be an alternate approach for management of similar cases.- - - - - - - - - - ranking = 4.9361279832919keywords = central nervous system, nervous system (Clic here for more details about this article) |
3/26. Chronic paronychia, osteomyelitis, and paravertebral abscess in a child with blastomycosis.blastomycosis is an unusual fungal infection in children. It is often a chronic infection characterized by granulomatous and suppurative lesions. Clinical manifestations include either pulmonary findings or disseminated disease. Disseminated blastomycosis usually begins with a lung infection that spreads to the skin, bones, and central nervous system. This is a case report of a child with chronic blastomycosis presenting with chronic paronychia, fever, cough, malaise, and back pain. The child underwent surgical drainage of a paravertebral abscess and administration of intravenous amphotericin b. He was discharged in good condition on oral therapy with ketoconazole. The literature on blastomycosis, with particular emphasis on clinical presentations and management, is reviewed. When the history and physical examination suggest a chronic granulomatous or disseminated disease, such as tuberculosis, the physician must include blastomycosis in the differential.- - - - - - - - - - ranking = 0.98722559665838keywords = central nervous system, nervous system (Clic here for more details about this article) |
4/26. amphotericin b lipid complex for the treatment of recurrent blastomycosis of the brain in a patient previously treated with itraconazole.This is the first reported case of cerebral blastomycosis successfully treated with amphotericin b lipid complex.- - - - - - - - - - ranking = 0.025548806683245keywords = brain (Clic here for more details about this article) |
5/26. Cutaneous blastomycosis.We report on a patient with cutaneous blastomycosis and no evidence of systemic involvement. This diagnosis was made on the basis of clinical findings and confirmed by histologic examination and results of culture. The primary lesion in blastomycosis is almost always pulmonary. However, occasionally, as in our patient, the pulmonic focus resolves spontaneously before the patient presents. Disseminated lesions occur most often in the skin, followed by bone, genitourinary tract, and central nervous system. Our patient had an excellent response to ketoconazole without adverse effects.- - - - - - - - - - ranking = 0.98722559665838keywords = central nervous system, nervous system (Clic here for more details about this article) |
6/26. Case report: treatment of blastomycosis with fluconazole.The authors present two cases of systemic blastomycosis successfully treated with fluconazole. In one case, the disease involved the respiratory tract, and the central nervous system was presumed to be involved. The second case consisted only of pulmonary blastomycosis. Both patients were treated with oral fluconazole 200 mg twice per day for 9 and 6 months, respectively. Treatment with this new triazole antifungal agent resulted in the complete resolution of the disease in both patients. They have remained asymptomatic for more than 6 months after the completion of therapy.- - - - - - - - - - ranking = 0.98722559665838keywords = central nervous system, nervous system (Clic here for more details about this article) |
7/26. Successful treatment of cerebral blastomycosis with voriconazole.blastomycosis can occasionally involve the central nervous system (CNS). amphotericin b deoxycholate is considered the drug of choice for the treatment of CNS blastomycosis. Significant toxicity may be associated with its use. We describe a case of cerebral blastomycoma that was successfully treated with voriconazole.- - - - - - - - - - ranking = 0.98722559665838keywords = central nervous system, nervous system (Clic here for more details about this article) |
8/26. Secondary intracerebral blastomycosis with giant yeast forms.Secondary central nervous system (CNS) blastomycosis is an unusual manifestation of blastomycosis. We report a case of recurrent intracerebral blastomycosis that presented histopathologically with giant yeast-like cells and multinucleation that mimicked coccidioides immitis. The yeast forms of blastomyces dermatitidis usually range in size from 8 to 20 microm in diameter. Large or giant yeast forms (20-40 microm) are rare. The four cases previously reported in the literature involving giant yeast cell forms of B. dermatitidis are reviewed here. Intracerebral blastomycosis should be suspected in patients with signs and symptoms of CNS lesions and histories of primary blastomycosis, or treatment with corticosteroids, or comprised immune systems. The diagnosis should be confirmed by culture which presents typical biphasic microbiologic features.- - - - - - - - - - ranking = 0.98722559665838keywords = central nervous system, nervous system (Clic here for more details about this article) |
9/26. fever, chills, and weakness in a 61-year-old man.A 61-year-old man presented to the emergency department of a community hospital with a 2-week history of fever, chills, and sudden extreme weakness of his right arm and lower extremities. He also had a cough, shortness of breath, nausea, abdominal pain, diarrhea, and myalgia. Though initially alert and cooperative, he quickly became unresponsive. In addition, he had hyponatremia, renal insufficiency, and compromised cardiopulmonary function. He was admitted to the intensive care unit for suspected bacterial infection and was started on broad-spectrum antibiotics. Chest radiograph revealed miliary infiltrates consistent with infectious emboli or metastatic carcinoma. Despite intensive resuscitation, the patient died 36 hours after admission. At autopsy multiple nodular lesions were observed on gross examination of the lungs, perihilar and paratracheal lymph nodes, and liver. Microscopic sections of the lung (Figure 1) and brain (Figures 2 and 3) are shown.- - - - - - - - - - ranking = 0.0063872016708112keywords = brain (Clic here for more details about this article) |
10/26. Recurrent central nervous system blastomycosis in an immunocompetent child treated successfully with sequential liposomal amphotericin b and voriconazole.central nervous system involvement in infection with blastomyces dermatitidis is uncommon, except in immunocompromised patients. We report a case of central nervous system blastomycosis occurring 18 months after treatment of pulmonary blastomycosis in an immunocompetent child. Our patient was successfully treated sequentially with liposomal amphotericin b followed by oral voriconazole without need for surgical resection.- - - - - - - - - - ranking = 5.1589542673225keywords = central nervous system, nervous system (Clic here for more details about this article) |
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