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烟曲霉引起的脑部侵袭性真菌性肉芽肿:一例报告并文献复习

Invasive fungal granuloma of the brain caused by Aspergillus fumigatus: a case report and review of the literature.

作者信息

Turgut Mehmet, Ozsunar Yelda, Oncü Serkan, Akyüz Orhan, Ertuğrul Mustafa B, Tekin Cengiz, Gültekin Berna, Sakarya Serhan

机构信息

Department of Neurosurgery, Adnan Menderes University School of Medicine, TR-09100 Aydin, Turkey.

出版信息

Surg Neurol. 2008 Feb;69(2):169-74; discussion 174. doi: 10.1016/j.surneu.2006.12.049. Epub 2007 Sep 6.

Abstract

BACKGROUND

Involvement of the brain by Aspergillus fumigatus, named as invasive aspergillosis, is extremely rare. Definitive diagnosis needs isolation of the fungus from the tissue specimens and its culture. The disease is very resistant to treatment and quickly becomes fatal despite antifungal chemotherapy with AmB preparations, the drugs of choice for the infection.

CASE DESCRIPTION

We hereby present a unique case of fungal granuloma of the brain due to A fumigatus, which was cured successfully by intensive antifungal treatment, along with a brief literature review.

CONCLUSIONS

Although it is rare, we draw the attention to the fact that early diagnostic procedures with rapid confirmation of Aspergillus infection and an early initiation of therapy are pivotal for a benign clinical course in such cases. A complete regression of the disease could be achieved with medical therapy alone with conventional AmB or liposomal AmB combined with oral itraconazole even if a total surgical excision of the lesions could not be performed in complicated cases, as in our patient.

摘要

背景

烟曲霉侵犯脑部,即侵袭性曲霉病,极为罕见。确诊需要从组织标本中分离出真菌并进行培养。该疾病对治疗具有很强的抵抗力,尽管使用两性霉素制剂(治疗该感染的首选药物)进行抗真菌化疗,病情仍会迅速恶化并导致死亡。

病例描述

我们在此呈现一例由烟曲霉引起的脑部真菌性肉芽肿的独特病例,该病例通过强化抗真菌治疗成功治愈,并进行了简要的文献综述。

结论

尽管这种情况罕见,但我们提请注意,早期诊断程序以及快速确认曲霉感染并尽早开始治疗对于此类病例的良好临床病程至关重要。即使在复杂病例中(如我们的患者)无法对病变进行完全手术切除,仅使用传统两性霉素或脂质体两性霉素联合口服伊曲康唑进行药物治疗也可使疾病完全消退。

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