Santana-Ramírez Adrián, Esparza-Gutiérrez Sergio V, Avila-Rodríguez Pedro, Jiménez-Gómez J Eugenio, Vélez-Gómez Ezequiel, Bañuelos-Gallo David
Department of Neurosurgery, Hospital Civil de Guadalajara Dr. Juan I Menchaca, Guadalajara, Jalisco, Mexico.
Department of Internal Medicine, Hospital Civil de Guadalajara Dr. Juan I Menchaca, Guadalajara, Jalisco, Mexico.
Surg Neurol Int. 2016 Dec 5;7(Suppl 39):S940-S946. doi: 10.4103/2152-7806.195230. eCollection 2016.
The presence of in the central nervous system (CNS) is rare in immunocompetent patients but not in immunocompromised patients who may have a more common infection. This article describes a case of an adult immunocompetent patient with a diagnosis of cerebral aspergillosis and with a clinical process of rapidly progressive dementia which simulated a Creutzfeldt-Jakob syndrome.
A 34-year-old adult was previously healthy and had no medical history of any significance. The patient had suffered only facial trauma 8 months before admission. One month prior to admission, he showed rapidly progressing changes in his behavior and higher mental functions. He was admitted to the emergency room with an occipital headache with 2 months of history. By the time he arrived, he suffered from total disability and was prostrate. He was diagnosed with meningeal and demential syndrome in the process of being studied. After starting the diagnostic approach by investigating cerebrospinal fluid, a magnetic resonance of the skull, an electroencephalogram, a brain biopsy was indicated. The histopathological study reported the presence of the hyphae characteristics of . The patient died 7 days after the diagnosis.
Cerebral aspergillosis is a common aggressive disease in immunosuppressed patients. However, the disease is rare in individuals with respected immunity and in individuals with neurological impairment and a rapid and progressive deterioration of mental functions. The suspected diagnosis should always be considered given its poor prognosis and the encouraging efficacy of antifungal treatment administered in a timely manner.
在免疫功能正常的患者中，中枢神经系统（CNS）出现这种情况较为罕见，但在可能发生更常见感染的免疫功能低下患者中并非如此。本文描述了一例成年免疫功能正常的患者，诊断为脑曲霉病，临床过程为快速进展性痴呆，类似于克雅氏综合征。
一名34岁的成年人既往健康，无任何重要病史。患者入院前8个月仅受过面部外伤。入院前1个月，他的行为和高级心理功能出现快速进展性变化。因枕部头痛2个月入院至急诊室。到院时，他已完全丧失能力，卧床不起。在检查过程中被诊断为脑膜和痴呆综合征。在开始通过检查脑脊液、头颅磁共振成像、脑电图进行诊断后，进行了脑活检。组织病理学研究报告显示存在曲霉菌的菌丝特征。患者在诊断后7天死亡。
脑曲霉病在免疫抑制患者中是一种常见的侵袭性疾病。然而，该疾病在免疫功能正常的个体以及伴有神经功能障碍和精神功能快速进展性恶化的个体中较为罕见。鉴于其预后不良以及及时给予抗真菌治疗的令人鼓舞的疗效，应始终考虑疑似诊断。
