Cerebral phaeohyphomycosis caused by ladophialophora bantiana and Fonsecaea monophora: report of three cases.
Cerebral phaeohyphomycosis caused by ladophialophora bantiana and Fonsecaea monophora: report of three cases.
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DOI：
10.5414/npp26021
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发表时间：
2007
影响因子：
1.1
通讯作者：
H. Takei;J. Goodman;S. Powell
中科院分区：
文献类型：
--
作者：
H. Takei;J. Goodman;S. Powell
本文报告三例脑暗色丝孢菌病。其中两例（病例1、2）由高度嗜神经真菌班氏刚毛瓶霉（Cladophialophora bantiana）引起，另一例（病例3）是美国首次报道的病例，由新定义的Fonsecaea bantihora引起。(Case 1）：一名65岁的女性因吉兰-巴雷综合征的假定诊断而接受治疗，发现右额叶有一个环形增强的充满液体的病变。病变抽吸两次，然后完全切除。(Case 2）：一名45岁的女性，有严重的皮肌炎病史，表现为左脑干亚急性缺血。约2个月后，患者发生急性阻塞性脑积水，并发现左侧环池、第四脑室和大脑导水管中有小囊性病变，这可能是由于栓塞/血栓导致的既往缺血症状。(Case 3）：一名62岁的肝移植后女性出现多处脑和骨肿瘤。从这些病变培养生长相同的真菌。组织学上，所有三个病例均显示多发性上皮样和巨细胞肉芽肿，伴有金棕色酵母样细胞群以及芽殖细胞链。例3可见散在的鼠状细胞，是着色芽生菌病的特征。在病例2和病例3中，真菌在冷冻切片上很容易识别，这可能被认为有助于确定术后治疗。
Three cases of cerebral phaeohyphomycosis are described. Two cases (Cases 1, 2) are caused by highly neurotropic fungi, Cladophialophora bantiana, and the other one (Case 3) is the first reported case in the United States, caused by the newly defined Fonsecaea monophora. (Case 1): A 65-year-old woman had been treated for a presumed diagnosis of Guillain-Barré syndrome and was found to have a ring-enhancing, fluid-filled lesion in the right frontal lobe. The lesion was aspirated twice and then resected completely. (Case 2): A 45-year-old woman with a history of severe dermatomyositis presented with subacute ischemia in the left brainstem. Approximately 2 months later, she developed acute obstructive hydrocephalus and was found to have small cystic lesions in the left ambient cistern, fourth ventricle and cerebral aqueduct, which had probably caused the previous ischemic symptoms due to emboli/ thrombi. (Case 3): A 62-year-old, post livertransplant woman developed multiple brain and bone abscesses. Cultures from these lesions grew the same fungi. Histologically, all three cases revealed multiple epithelioid and giant cell granulomata with groups of golden-brown yeast-like cells as well as chains of budding cells. In Case 3, scattered muriform cells, characteristic of chromoblastomycosis, were present. In Cases 2 and 3, the fungi were easily identified on frozen sections, which may be considered useful in determining post-operative therapy.