一名2岁儿童在近乎溺水事件后，成功治疗多发性博伊德假阿利什霉脑脓肿及脑室炎/室管膜炎。
Successful treatment of multiple Pseudallescheria boydii brain abscesses and ventriculitis/ependymitis in a 2-year-old child after a near-drowning episode.
作者信息
Mursch Kay, Trnovec Svorad, Ratz Heinrich, Hammer Detlef, Horré Regine, Klinghammer Albrecht, de Hoog Sybren, Behnke-Mursch Julianne
机构信息
Department of Neurosurgery, Zentralklinik, Robert-Koch Allee 9, 99438, Bad Berka, Germany.
出版信息
Childs Nerv Syst. 2006 Feb;22(2):189-92. doi: 10.1007/s00381-005-1151-3. Epub 2005 Apr 30.
RATIONALE
We report on a cerebral infection by Pseudallescheria boydii in a 21-month-old boy after a near-drowning episode. MRI revealed multiple (> 60) intracerebral abscesses.
METHODS
The surgical therapy included CSF drainage and microsurgical resection of one abscess for microbiological diagnosis. Antimycotic therapy included terbinafine and intraventricular caspofungin in addition to voriconazole.
RESULTS
Systemic side effects of chemotherapy were not observed. After placement of a ventriculoperitoneal shunt, the boy was transferred to a rehabilitation clinic and improved neurologically. After 20 months, MRI documented a continuing remission of the disease.
CONCLUSION
Our case proves that an aggressive treatment should be undertaken and can be successful in CNS pseudallescheriasis.
原理
我们报告了一名21个月大男孩在近乎溺水事件后发生的博伊德假阿利什霉脑感染。磁共振成像（MRI）显示有多个（>60个）脑内脓肿。
方法
手术治疗包括脑脊液引流以及为进行微生物学诊断而对一个脓肿进行显微手术切除。抗真菌治疗除伏立康唑外，还包括特比萘芬和脑室内卡泊芬净。
结果
未观察到化疗的全身性副作用。在置入脑室腹腔分流管后，该男孩被转至康复诊所，神经功能有所改善。20个月后，MRI记录显示疾病持续缓解。
结论
我们的病例证明，对于中枢神经系统假阿利什霉病应采取积极治疗且可能取得成功。
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