Sharma R R, Gurusinghe N T, Lynch P G
Royal Preston Hospital, Lancs, UK.
Br J Neurosurg. 1992;6(5):485-90. doi: 10.3109/02688699208995040.
Cerebral infarction due to fungal arteritis is an uncommon complication of neurosurgical operations and adjuvant immunosuppressive therapy, including long-term steroids. If unrecognized, the neurological deterioration which ensues may be mistreated by increasing the dose of steroids. A case of a 38-year-old Caucasian male who had no obvious immune deficiency or fungal infection prior to a craniotomy for cerebral tumour is described in whom perioperative aspergillus infection resulted in cerebral arteritis and extensive cerebral infarction with a fatal outcome. Long-term steroid therapy used in the management of cerebral tumours may carry an increased risk of systemic or cerebral fungal infection. The possibility of cerebral mycosis (arteritis) and dangers of its non-recognition are highlighted.
真菌性动脉炎所致脑梗死是神经外科手术及辅助免疫抑制治疗(包括长期使用类固醇)的一种罕见并发症。如果未被识别,随后出现的神经功能恶化可能会因增加类固醇剂量而被误诊。本文描述了一例38岁的白种男性,在因脑肿瘤行开颅手术前无明显免疫缺陷或真菌感染,其围手术期曲霉菌感染导致脑动脉炎和广泛脑梗死,最终死亡。用于治疗脑肿瘤的长期类固醇治疗可能会增加全身或脑部真菌感染的风险。强调了脑霉菌病(动脉炎)的可能性及其未被识别的危险性。