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[脑暗色丝孢霉病:1例病例描述及文献复习]

[Cerebral phaeohyphomycosis: description of a case and review of the literature].

作者信息

Frasquet-Artés Juan S, Pemán Javier, Blanes Marino, Hernández-Porto Miriam, Cano Josep, Jiménez-Herrero Enrique, López-Hontangas José Luis

机构信息

Servicio de Microbiología, Hospital Universitario y Politécnico La Fe, Valencia, España.

Servicio de Microbiología, Hospital Universitario y Politécnico La Fe, Valencia, España.

出版信息

Rev Iberoam Micol. 2014 Jul-Sep;31(3):197-202. doi: 10.1016/j.riam.2012.12.008. Epub 2013 Feb 9.

Abstract

Cerebral phaeohyphomycosis is a rare invasive fungal infection with very few cases referenced in the literature. There is no standardized treatment, and it is associated with poor outcomes. Cladophialophora bantiana, a fungus with special tropism for the central nervous system, is one of the causal agents of phaeohyphomycosis. The case presented here deals with a brain abscess by C. bantiana in an adult with Crohn's disease had beed being treated with immunosuppressive drugs. Despite the correct etiological diagnosis, surgical and pharmacological treatments, the patient died 32 days after surgery. A description of the case is followed by a review of all cerebral C. bantiana phaeohyphomycosis cases published in the last 10 years. Regardless of the use of advanced new imaging techniques in the diagnosis and treatment with new antifungal agents, cerebral phaeohyphomycosis by C. bantiana continues to have very poor prognosis. While new more successful therapeutic treatments appear, a combined surgical and pharmacological approach seems to be more appropriate for this severe mycosis.

摘要

脑暗色丝孢霉病是一种罕见的侵袭性真菌感染,文献中提及的病例很少。目前尚无标准化治疗方法,且其预后较差。班替枝孢霉是一种对中枢神经系统有特殊嗜性的真菌,是暗色丝孢霉病的病原体之一。本文介绍了一例成年克罗恩病患者因使用免疫抑制药物治疗而发生的由班替枝孢霉引起的脑脓肿病例。尽管进行了正确的病因诊断、手术和药物治疗,但患者在术后32天死亡。病例描述之后是对过去10年发表的所有班替枝孢霉引起的脑暗色丝孢霉病病例的综述。尽管在诊断和使用新型抗真菌药物治疗中采用了先进的新成像技术,但班替枝孢霉引起的脑暗色丝孢霉病预后仍然很差。虽然出现了更成功的新治疗方法,但联合手术和药物治疗似乎更适合这种严重的真菌病。

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