Noritomi Danilo Teixeira, Bub Guilherme Linhares, Beer Idal, da Silva Aloísio Souza Felipe, de Cleva Roberto, Gama-Rodrigues Joaquim José
Gastroenterology Department, Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, SP, Brazil.
Rev Inst Med Trop Sao Paulo. 2005 May-Jun;47(3):167-70. doi: 10.1590/s0036-46652005000300010. Epub 2005 Jul 12.
We present a case of central nervous system (CNS) infection by a member of the Penicillium genera in a HIV-negative man in Brazil. The patient was admitted complaining of loss of visual fields and speech disturbances. CT scan revealed multiple brain abscesses. Stereotactic biopsies revealed fungal infection and amphotericin B treatment begun with initial improvement. The patient died few days later as a consequence of massive gastrointestinal bleeding due to ruptured esophageal varices. The necropsy and final microbiologic analyses disclosed infection by Penicillium sp. There are thousands of fungal species of the Penicillium genera. Systemic penicilliosis is caused by the P. marneffei and was formerly a rare disease, but now is one of the most common opportunistic infection of AIDS patients in Southeast Asia. The clinical presentation usually involves the respiratory system and the skin, besides general symptoms like fever and weight loss. Penicillium spp infection caused by species other than P. marneffei normally cause only superficial or allergic disease but rare cases of invasive disease do occur. We report the fourth case of Penicillium spp CNS infection.
我们报告了巴西一名HIV阴性男子感染青霉菌属导致中枢神经系统（CNS）感染的病例。该患者因视野缺损和言语障碍入院。CT扫描显示多处脑脓肿。立体定向活检显示真菌感染，开始使用两性霉素B治疗，最初病情有所改善。患者几天后因食管静脉曲张破裂导致大量胃肠道出血而死亡。尸检和最终微生物学分析显示为青霉菌感染。青霉菌属有数千种真菌。系统性青霉病由马尔尼菲青霉菌引起，以前是一种罕见疾病，但现在是东南亚艾滋病患者最常见的机会性感染之一。临床表现通常累及呼吸系统和皮肤，此外还有发热和体重减轻等全身症状。由马尔尼菲青霉菌以外的其他种类青霉菌引起的感染通常仅导致浅表或过敏性疾病，但确实会发生罕见的侵袭性疾病病例。我们报告了第四例青霉菌属中枢神经系统感染病例。
