Simon Márta, Vastagh Ildikó, Várallyay György, Turányi Eszter, Sréter Lídia, Czirják Sándor, Bereczki Dániel
Semmelweis Egyetem, Neurológiai Klinika, Budapest.
Ideggyogy Sz. 2010 May 30;63(5-6):193-6.
Aspergillus infection of the central nervous system is a rare disease, occasionally seen among immunocompromised patients. The most frequent pathway is hematogenic dissemination. Less known is the direct propagation from the paranasal sinuses, which is usually observed in immunocompetent patients. We report a patient who developed cavernous sinus syndrome due to an invasive intracranial aspergilloma after longlasting chemo- and steroid therapy for chronic lymphoid leukemia and immunhemolytic anemia. The characteristic features seen on radiological images--brain CT and MRI--suggested the possibility of invasive aspergilloma. Postoperative histology defined the diagnosis. Our case review highlights the importance of considering the possibility of an invasive opportunistic infection of the CNS in an immunocompromised patient presenting a new neurological sign.
中枢神经系统曲霉菌感染是一种罕见疾病,偶尔见于免疫功能低下的患者。最常见的传播途径是血行播散。经鼻旁窦直接蔓延则鲜为人知,这种情况通常见于免疫功能正常的患者。我们报告一例患者,该患者在接受针对慢性淋巴细胞白血病和免疫性溶血性贫血的长期化疗和类固醇治疗后,因侵袭性颅内曲霉菌瘤而出现海绵窦综合征。脑部CT和MRI等影像学检查所见的特征提示侵袭性曲霉菌瘤的可能性。术后组织学检查明确了诊断。我们的病例回顾强调,对于出现新的神经系统症状的免疫功能低下患者,考虑中枢神经系统发生侵袭性机会性感染的可能性具有重要意义。