Kershaw P, Freeman R, Templeton D, DeGirolami P C, DeGirolami U, Tarsy D, Hoffmann S, Eliopoulos G, Karchmer A W
Department of Neurology, Boston City Hospital, MA.
Arch Neurol. 1990 Apr;47(4):468-72. doi: 10.1001/archneur.1990.00530040126029.
Pseudallescheria boydii is a rare cause of central nervous system infection characteristically presenting as a neutrophilic meningitis or multiple brain abscesses. Factors predisposing to central nervous system infection with this fungus include immunosuppression and near drowning. The organism is infrequently cultured from fluid obtained by lumbar puncture, delaying clinical recognition and appropriate antifungal therapy. All untreated patients with P boydii infection of the central nervous system died. We describe a patient who developed a persistent neutrophilic meningitis with focal neurologic deficits due to P boydii 6 months after a freshwater aspiration pneumonia. We also review the characteristic clinical and pathologic features of previously reported cases and emphasize the importance of early detection and treatment in the management of this frequently intractable disease.
波氏假阿利什霉是中枢神经系统感染的罕见病因，其典型表现为嗜中性粒细胞性脑膜炎或多发性脑脓肿。易引发该真菌中枢神经系统感染的因素包括免疫抑制和近乎溺水。通过腰椎穿刺获取的液体中很少培养出该病原体，这会延迟临床诊断及适当的抗真菌治疗。所有未接受治疗的中枢神经系统感染波氏假阿利什霉的患者均死亡。我们描述了一名患者，该患者在淡水吸入性肺炎6个月后因波氏假阿利什霉感染出现持续性嗜中性粒细胞性脑膜炎并伴有局灶性神经功能缺损。我们还回顾了既往报道病例的特征性临床和病理特征，并强调早期检测和治疗在管理这种常难以治疗的疾病中的重要性。
