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Cerebral aspergillosis

Sébastien Imbert, Jean-Yves Brossas, Martine Palous, Isabelle Joly, Isabelle Meyer, Arnaud Fekkar
OBJECTIVES: cerebral aspergillosis is a rare but often fatal form of invasive aspergillosis that remains difficult to diagnose. The literature has shown the value of Aspergillus PCR in blood-derived samples for the diagnosis of invasive aspergillosis but provides far less information for cerebrospinal fluid (CSF) in cerebral aspergillosis. Here, we evaluated the usefulness of an Aspergillus PCR assay performed on CSF for the diagnosis of cerebral aspergillosis. METHODS: this retrospective study involved 72 patients with suspected cerebral aspergillosis for a total of 88 CSF samples in whom CSF Aspergillus PCR was performed...
June 19, 2017: Clinical Microbiology and Infection
Christian Grommes, Anas Younes
In this issue of Cancer Cell, Lionakis et al. demonstrate that the combination of temozolomide, etoposide, doxorubicin, dexamethasone, rituximab, and the Bruton tyrosine kinase (BTK) inhibitor ibrutinib induced frequent responses in patients with primary central nervous system lymphoma but was associated with significant toxicity, including pulmonary and cerebral aspergillosis infections.
June 12, 2017: Cancer Cell
Saleh S Baeesa, Rakan F Bokhari, Khalid B Alghamdi, Hisham B Alem, Jaudah A Al-Maghrabi, Tariq A Madani
CONTEXT: Invasive sinonasal aspergillosis is a silently progressive disease that, left untreated, may invade the adjacent intracranial and intra-orbital compartments incurring serious morbidity. AIM: To evaluate our results of a collaborative surgical management plans for patients with invasive sinonasal aspergillosis with orbitocranial extension. SETTING AND DESIGN: Retrospective study. MATERIALS AND METHODS: Between the years 2000 and 2012, 12 patients with Aspergillus sinusitis with orbitocranial extension were treated at our institution...
April 2017: Asian Journal of Neurosurgery
Tapan Kavi, Nikhil Madan, Tamara Majic, Axel Rosengart, Marcel Maya, Serguei Bannykh, Shouri Lahiri
INTRODUCTION: Invasive cerebral aspergillosis is an uncommon cause of stroke among immunocompetent patients and has not been reported in association with cardiac surgery or extracorporeal membrane oxygenation (ECMO). We report the case of an immunocompetent host who developed aspergillus-associated stroke following coronary artery bypass graft (CABG) and ECMO. CASE REPORT: A 59-year-old woman developed cardiogenic shock after 3-vessel-CABG requiring intra-aortic balloon pump placement and subsequent veno-arterial ECMO...
May 2017: Neurologist
Giselle de Martin Truzzi, Henrique Furlan Pauna, Igor Moreira Hazboun, Igor Benedick Coimbra, Emerson Taro Inoue Sakuma, Icléia Siqueira Barreto, Carlos Takahiro Chone, Eulalia Sakano
This is a report of a patient with aspergillosis infection, which was thought to be a tumoral lesion during its investigation. This is not a common disease in Western countries, and this report should increase our awareness for differential diagnosis of nasal masses. Early diagnosis is desired in order to increase the survival rates.
March 2017: Clinical Case Reports
Romain Sonneville, Eric Magalhaes, Geert Meyfroidt
PURPOSE OF REVIEW: Although rare, central nervous system (CNS) infections are increasingly being recognized in immunocompromised patients. The goal of the present review is to provide a practical diagnostic approach for the intensivist, and to briefly discuss some of the most prevalent conditions. RECENT FINDINGS: Immunocompromised patients presenting with new neurological symptoms should always be suspected of a CNS infection. These infections carry a poor prognosis, especially if intracranial hypertension, severely altered mental status or seizures are present...
April 2017: Current Opinion in Critical Care
Sakon Noriki, Kazuyuki Kinoshita, Kunihiro Inai, Toyohiko Sakai, Hirohiko Kimura, Takahiro Yamauchi, Masayuki Iwano, Hironobu Naiki
BACKGROUND: Postmortem imaging (PMI) refers to the imaging of cadavers by computed tomography (CT) and/or magnetic resonance imaging (MRI). Three cases of cerebral infarctions that were not found during life but were newly recognized on PMI and were associated with severe systemic infections are presented. CASE PRESENTATIONS: An 81-year-old woman with a pacemaker and slightly impaired liver function presented with fever. Imaging suggested interstitial pneumonia and an iliopsoas abscess, and blood tests showed liver dysfunction and disseminated intravascular coagulation (DIC)...
January 10, 2017: BMC Medical Imaging
Dipu Sathyapalan, Sabarish Balachandran, Anil Kumar, Bindu Mangalath Rajamma, Ashok Pillai, Vidya P Menon
35 yr old steroid dependent lady with Pulmonary TB underwent debridement of epidural abscess & posterior stabilization for paraparesis. With histopathology and cultures showing Aspergillus fumigatus, voricanozole was started. By the fourth week, she developed persistent fever, and altered mental status. Brain MRI and CSF study including multiplex PCR evaluation confirmed cerebral aspergillosis. Voricanozole was changed to intravenous lipid complex Amphotericin B to achieve sustained clinical and radiological response after six months of therapy...
December 2016: Medical Mycology Case Reports
Matthew William McCarthy, Thomas J Walsh
In September 2012, the Centers for Disease Control and Prevention (CDC) began investigating an outbreak of fungal meningitis among patients who had received contaminated preservative-free methyl prednisolone acetate injections from the New England Compounding Center in Framingham, Massachusetts. Thousands of patients were potentially exposed to tainted corticosteroids, but establishing the diagnosis of fungal meningitis during the nationwide outbreak was difficult because little was known about the natural history of the disease...
February 2017: Expert Review of Molecular Diagnostics
Mohsen Meidani, Atousa Hakamifard, Amir Hossein Sarrami
Central nervous system (CNS) aspergillosis is uncommon and considered the most lethal form of aspergillosis. Indeed, current therapeutic strategies such as combination antifungal regimen, neurosurgical resection of infected tissue, and removal of infection source fail to improve the unsatisfactory prognosis of CNS aspergillosis in the majority of the patients. The authors describe a case of chronic pulmonary aspergillosis with concomitant CNS lesions that dramatically responded to antifungal therapy and the CNS lesions resolved in follow-up imaging...
October 2016: Asian Journal of Neurosurgery
J Luo, X Wang, Y Yang, T Lan, M A Ashraf, Q Mao
We report a case of a patient with AIDS and a brain abscess caused by aspergillus, who underwent neurosurgical excision of the lesion and received subsequent therapy with voriconazole. The patient suffered from intracranial hypertension and visual disorders.
April 18, 2016: West Indian Medical Journal
Despoina Voultsinou, Georgios Matis, Danilo Silva, Olga Chrysou, Theodossios Birbilis, Panagiotis Palladas, Triantafillos Geroukis
No abstract text is available yet for this article.
September 2015: Acta Neurologica Taiwanica
Muhammed Waqas, Sidra Zafar, Tooba Rehman, Muhammed Riyaz, Muhammed E Bari, Romana Idrees
BACKGROUND: Chronic granulomatous disease (CGD) is an immune disorder that affects phagocytes. It is characterized by recurrent or persistent bacterial and fungal infections. Reports of tuberculosis (TB) in patients with CGD are rare. In developing countries, where TB is endemic, possibility of other chronic infections is often overlooked by physicians. CASE DESCRIPTION: We report the case of a 4-year-old boy who had recurrent respiratory infections and episodes of headache...
2016: Surgical Neurology International
Guillaume Marzolf, Marcela Sabou, Béatrice Lannes, François Cotton, David Meyronet, Damien Galanaud, Jean-Philippe Cottier, Sylvie Grand, Hubert Desal, Julie Kreutz, Maleka Schenck, Nicolas Meyer, Francis Schneider, Jean-Louis Dietemann, Meriam Koob, Raoul Herbrecht, Stéphane Kremer
Cerebral aspergillosis is associated with a significant morbidity and mortality rate. The imaging data present different patterns and no full consensus exists on typical imaging characteristics of the cerebral lesions. We reviewed MRI findings in 21 patients with cerebral aspergillosis and correlated them to the immune status of the patients and to neuropathological findings when tissue was available. The lesions were characterized by their number, topography, and MRI signal. Dissemination to the brain resulted from direct spread from paranasal sinuses in 8 patients, 6 of them being immunocompetent...
2016: PloS One
Ruo-Xi Wang, Jia-Tang Zhang, Yu Chen, Xu-Sheng Huang, Wei-Quan Jia, Sheng-Yuan Yu
PURPOSE: Aspergillosis of the central nervous system is very rare. However with recent increases in the use of immunosuppressive agents and antibiotics, its incidence is increasing. We evaluated the demographics, clinical manifestations, laboratory findings, diagnosis, underlying conditions, treatment regimens and outcomes of patients with cerebral aspergillosis (CA). METHODS: We retrospectively reviewed data from eight patients with CA hospitalized at a Chinese general hospital from 1 January 2005 to 30 September 2015...
April 2017: International Journal of Neuroscience
Hung-Jen Tang, Wei-Lun Liu, Tsung Chain Chang, Ming-Chi Li, Wen-Chien Ko, Chi-Jung Wu, Yin-Ching Chuang, Chih-Cheng Lai
Invasive cerebral aspergillosis always developed in immunocompromised host. Early diagnosis may save life in this critical condition; however, it is difficult to reach. Herein, we presented an unusual case of invasive cerebral aspergillosis in a cirrhotic patient. A 47-year-old man presented with progressive deterioration of consciousness for three days. The patient had a history of alcoholic liver cirrhosis, Child-Pugh class C. Magnetic resonance imaging (MRI) of brain showed multi-focal parenchymal lesions, which was consistent with multiple brain abscesses...
March 2016: Medicine (Baltimore)
Jonathan Richard Ellenbogen, Mueez Waqar, Richard P D Cooke, Mohsen Javadpour
Cerebral aspergillosis, is an infrequent, opportunistic infection of the central nervous system that accounts for 5-10% of all intracranial fungal pathology. It is uncommon in immunocompetent patients and has a significant disease burden, with high morbidity and mortality, even with appropriate treatment. Basic principles of abscess management should be employed, including aspiration and targeted anti-fungal therapy for 12-18 months. However, reported outcomes with a purely minimally invasive approach are poor and there should be a low threshold for surgical excision, especially in resource poor settings and in patients with deteriorating neurology harbouring sizeable masses...
June 2016: British Journal of Neurosurgery
Shailendra Shrestha, John Kanellis, Tony Korman, Kevan R Polkinghorne, Fiona Brown, Ming Yii, Peter G Kerr, William Mulley
AIM: Nocardia infections are an uncommon but important cause of morbidity and mortality in renal transplant recipients. The present study was carried out to determine the spectrum of Nocardia infections in a renal transplant centre in Australia. METHODS: A retrospective chart analysis of all renal transplants performed from 2008 to 2014 was conducted to identify cases of culture proven Nocardia infection. The clinical course for each patient with nocardiosis was examined...
March 2016: Nephrology
G M Chong, J A Maertens, K Lagrou, G J Driessen, J J Cornelissen, B J A Rijnders
Testing cerebrospinal fluid (CSF) for the presence of galactomannan (GM) antigen may help in diagnosing cerebral aspergillosis (CA). However, the use of the CSF GM test as a diagnostic test has been little studied. We evaluated its diagnostic performance by comparing the CSF GM optical density indexes (ODI) at different cutoffs in patients with probable and proven CA to those in patients without CA. Patients from 2 tertiary referral hospitals with suspected CA between 2004 and 2014 and in whom CSF GM ODI had been determined were selected...
February 2016: Journal of Clinical Microbiology
Tae-Seok Kim, Keun Soo Ahn, Yong Hoon Kim, Hyoung Tae Kim, Byoung Kuk Jang, Jae Seok Hwang, Il-Man Kim, Yu Na Kang, Koo Jeong Kang
Invasive aspergillosis is one of the most important and fatal complications after liver transplant, especially in patients with involvement of the central nervous system. We present a case of a patient who developed cerebral and pulmonary aspergillosis, coinfected with cytomegalovirus, after liver transplant for toxic fulminant hepatitis. The patient was treated successfully with neurosurgical intervention and voriconazole. Voriconazole is considered more effective in cerebral aspergillosis than other anti-fungal agents due to the greater penetration into central nervous system and higher cerebrospinal fluid and brain tissue levels...
February 2017: Experimental and Clinical Transplantation
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