CNS aspergillosis with mycotic aneurysm, cerebral granuloma and infarction
CNS aspergillosis with mycotic aneurysm, cerebral granuloma and infarction
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DOI：
10.1007/s00701-004-0292-6
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发表时间：
2004-07-01
影响因子：
2.4
通讯作者：
Deruytter, MJ
中科院分区：
文献类型：
--
作者：
Ho, CL;Deruytter, MJ
我们报告一位免疫功能低下的侵袭性曲霉菌病患者，他发展为曲霉肉芽肿和小脑上级动脉的肌层动脉瘤。中枢神经系统（CNS）的感染途径是从肺部病灶血行播散。用半乳甘露聚糖（GM）技术检测IA。然而，尽管用阿替霉素B治疗，血管壁仍发生进展性受累，导致致命性蛛网膜下腔出血和大面积脑干和小脑梗死。本例提供了一种最具破坏性的真菌累及CNS与真菌性动脉瘤的病理-影像学相关性。最后，对中枢神经系统曲霉菌病的发病机制、诊断调查和治疗的文献进行了综述。
We are reporting a case of an immunocompromised patient with invasive aspergillosis (IA) who developed aspergillotic granulomas and a mycotic aneurysm of the superior cerebellar artery. The route of infection of the central nervous system (CNS) was hematogenous spread from a pulmonary focus. IA was detected with the Galactomannan (GM) technique. However, despite treatment with amphotericin B, progressive involvement of the vessel wall occurred causing fatal subarachnoid hemorrhage and massive brainstem and cerebellar infarction.This case provides pathologic-imaging correlation of one of the most devastating types of fungal involvement affecting the CNS with a fungal aneurysm. Finally the literature regarding the pathogenetic, and diagnostic investigations and the management of CNS aspergillosis is reviewed.