1/35. A case of hiv-associated cerebral histoplasmosis successfully treated with fluconazole.Clinically apparent involvement of the central nervous system is a rare event in cases of disseminated histoplasmosis, even in hiv-infected persons. Despite therapy with amphotericin b, mortality remains very high. Reported here is the case of an hiv-infected patient with a 3-month history of fever, cough, weight loss and miliary lung infiltrates. Four weeks after initiation of tuberculostatic therapy, high-grade fever, neurological symptoms, personality changes and respiratory deterioration occurred. magnetic resonance imaging of the brain showed multiple mass lesions, and a chest radiograph revealed worsening of pulmonary infiltrates. methenamine silver staining of a lung biopsy specimen demonstrated histoplasma capsulatum. Subsequently, this pathogen was cultured from lavage fluid. Following high-dose intravenous fluconazole therapy (800 mg once daily), the patient's condition improved markedly within 10 days, followed by an almost complete resolution of pulmonary and cerebral mass lesions. This is believed to be the first documented case of rapid improvement of disseminated histoplasmosis with central nervous system involvement in an hiv-infected patient upon induction of therapy with fluconazole.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
2/35. Microascus cinereus (Anamorph scopulariopsis) brain abscess in a bone marrow transplant recipient.We report the first documented case of brain abscess due to the dematiaceous fungus Microascus cinereus, an organism common in soil and stored grain. M. cinereus was isolated from brain abscess material from a bone marrow transplant recipient. The patient responded well to treatment by amphotericin b lipid complex, itraconazole, and a craniotomy but later died from secondary complications caused by graft-versus-host disease.- - - - - - - - - - ranking = 0.082594642035968keywords = brain (Clic here for more details about this article) |
3/35. 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 = 0.12511986632782keywords = nervous system (Clic here for more details about this article) |
4/35. 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 = 2.4655855658183keywords = central nervous system, nervous system (Clic here for more details about this article) |
5/35. 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 = 0.62559933163912keywords = nervous system (Clic here for more details about this article) |
6/35. Acute isolated cerebral mucormycosis in a patient with high grade non-Hodgkins lymphoma.A 57-year-old female in complete remission of grade IV non-Hodgkin lymphoma whilst on intensive chemotherapy, suddenly developed unilateral hemispheric stroke with a fatal outcome in 3 days. She was apyrexial and had received antifungal prophylaxis during her treatment. Post-mortem examination showed complete thrombosis of the internal carotid artery leading to infarction in the territory of the middle and anterior cerebral arteries. Microscopic examination of the brain showed involvement of intra-cranial vessel walls and brain parenchyma by mucormyces, with no evidence of systemic mucormycosis. Isolated cerebral mucormycosis is a rare occurrence, more commonly found in intravenous drug abusers, but can occur in patients with haematological malignancy.- - - - - - - - - - ranking = 0.027531547345323keywords = brain (Clic here for more details about this article) |
7/35. Ramichloridium mackenziei brain abscess: report of two cases and review of the literature.We report two cases of brain abscesses caused by Ramichloridium mackenziei, a neurotropic dematiaceous fungus that seems to be geographically restricted to the middle east. One of the patients had chronic myelomonocytic leukemia but did not receive any chemotherapeutic agents. The other patient was a normal host. Both cases had a fatal outcome despite aggressive antifungal therapy and surgical intervention. Herein, we review all previously described cases in the literature, and discuss the epidemiology, mycology and histopathology of this life-threatening organism.- - - - - - - - - - ranking = 0.068828868363306keywords = brain (Clic here for more details about this article) |
8/35. 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 = 0.055063094690645keywords = brain (Clic here for more details about this article) |
9/35. 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 = 0.50688288683633keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
10/35. 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 = 0.068828868363306keywords = brain (Clic here for more details about this article) |
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