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小脑曲霉病:病例报告及文献综述

Cerebellar aspergillosis: case report and literature review.

作者信息

Erdogan Ersin, Beyzadeoglu Murat, Arpaci Fikret, Celasun Bülent

机构信息

Department of Neurosurgery, Gulhane Military Medical School, Ankara, Turkey.

出版信息

Neurosurgery. 2002 Apr;50(4):874-6; discussion 876-7. doi: 10.1097/00006123-200204000-00036.

Abstract

OBJECTIVE AND IMPORTANCE

An unusual, but not unique, case of cerebellar aspergillosis associated with autologous peripheral blood stem cell transplantation for breast cancer is presented.

CLINICAL PRESENTATION

A 45-year-old woman with breast cancer underwent chemotherapy and radiotherapy as well as autologous peripheral blood stem cell transplantation. She developed a cerebellar aspergillosis abscess that was treated successfully with two surgical resections.

INTERVENTION

After removal of pus and the abscess wall, the patient received local application of amphotericin B (AmB). She received AmB 1 mg/kg/d for 3 months and itraconazole 100 mg/kg/d for 1 year. After 3 months of AmB treatment, magnetic resonance imaging revealed that disease had not recurred.

CONCLUSION

In cases of central nervous system aspergillosis, to increase the therapeutic efficiency, AmB can also be applied to the abscess cavity. Computed tomographic and contrast-enhanced magnetic resonance imaging scans play an important role in establishing early diagnosis in high-risk, immunocompromised patients.

摘要

目的与重要性

本文介绍了一例不常见但并非独一无二的小脑曲霉菌病病例,该病例与乳腺癌自体外周血干细胞移植相关。

临床表现

一名45岁乳腺癌女性接受了化疗、放疗以及自体外周血干细胞移植。她患上了小脑曲霉菌病脓肿,通过两次手术切除成功治愈。

干预措施

清除脓液和脓肿壁后,患者接受了两性霉素B(AmB)局部应用。她接受了3个月的AmB治疗,剂量为1mg/kg/天,以及1年的伊曲康唑治疗,剂量为100mg/kg/天。AmB治疗3个月后,磁共振成像显示疾病未复发。

结论

在中枢神经系统曲霉菌病病例中,为提高治疗效果,AmB也可应用于脓肿腔。计算机断层扫描和增强磁共振成像扫描在高危免疫功能低下患者的早期诊断中起重要作用。

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