Epstein N E, Hollingsworth R, Black K, Farmer P
Department of Surgery, North Shore University Hospital, Manhasset, New York.
Surg Neurol. 1991 Apr;35(4):286-9. doi: 10.1016/0090-3019(91)90006-u.
Although the mortality rate for fungal brain abscesses in immunosuppressed patients remains unacceptably high, this figure may be reduced if computed tomography or magnetic resonance imaging scans are performed more promptly in susceptible individuals with seemingly mild intracranial complaints. Earlier presumptive amphotericin B treatment and more timely surgical debridement may minimize neurological injury and enhance survival. These assumptions were only tentatively supported by the clinical courses of two patients, one an alert patient with promyelocytic leukemia and an aspergillosis brain abscess who survived, and the other, a comatose intravenous drug abuser with mucormycosis who died.
尽管免疫抑制患者真菌性脑脓肿的死亡率仍然高得令人难以接受,但如果对有看似轻微颅内症状的易感个体更迅速地进行计算机断层扫描或磁共振成像扫描,这一数字可能会降低。早期的两性霉素B经验性治疗和更及时的手术清创可能会将神经损伤降至最低并提高生存率。这些假设仅从两名患者的临床病程中得到了初步支持,一名是患有早幼粒细胞白血病和曲霉菌性脑脓肿且存活下来的清醒患者,另一名是患有毛霉菌病的昏迷静脉药物滥用者,后者死亡。