Surash S, Tyagi A, De Hoog G S, Zeng J S, Barton R C, Hobson R P
Department of Neurosurgery, Leeds General Infirmary, Leeds, UK.
Med Mycol. 2005 Aug;43(5):465-72. doi: 10.1080/13693780500220373.
We report a case of cerebral phaeohyphomycosis in a 53-year-old immunocompetent diabetic male, caused by Fonsecaea monophora. Computerized tomography of the brain revealed an abscess, which yielded F. monophora in pure culture. The patient's condition deteriorated on treatment with voriconazole and 5-fluorocytosine, and improved subsequently with high-dose itraconazole. The genus Fonsecaea has recently been revised and the new species F. monophora generated from molecular analysis of isolates, most of which were originally identified as Fonsecaea pedrosoi. This is the fourth case of cerebral infection known to have been caused by F. monophora, although only the first reported as such. These cases suggest that the clinical potential of F. monophora differs from that of F. pedrosoi, one of the main agents of chromoblastomycosis, with F. monophora being predominantly neurotropic in the human host.
我们报告一例由单孢瓶霉引起的脑暗色丝孢霉病，患者为一名53岁免疫功能正常的糖尿病男性。脑部计算机断层扫描显示有一个脓肿，从中分离出的纯培养物为单孢瓶霉。患者在接受伏立康唑和5-氟胞嘧啶治疗后病情恶化，随后使用高剂量伊曲康唑病情好转。瓶霉属最近经过修订，通过对分离株的分子分析产生了新物种单孢瓶霉，其中大多数最初被鉴定为裴氏瓶霉。这是已知由单孢瓶霉引起的第四例脑部感染病例，尽管这是首次如此报道。这些病例表明，单孢瓶霉的临床特性与着色芽生菌病的主要病原体之一裴氏瓶霉不同，单孢瓶霉在人类宿主中主要具有嗜神经性。
