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免疫功能正常儿童的荚膜组织胞浆菌感染,误诊为脑肿瘤。

Saksenaea infection masquerading as a brain tumor in an immunocompetent child.

机构信息

Department of Pathology, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA.

Department of Neurosurgery, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA.

出版信息

Neuropathology. 2019 Oct;39(5):382-388. doi: 10.1111/neup.12585. Epub 2019 Aug 2.

Abstract

Saksenaea species are a rare cause of mucormycosis, the majority associated with cutaneous and subcutaneous infections resulting from trauma in both immunocompromised and immunocompetent individuals. Unlike other causative agents of mucormycosis, cerebral infections are exceptionally rare. We describe the first case of isolated cerebral infection by Saksenaea in a 4-year-old previously healthy male child who presented with headaches. He had no past medical history other than an episode of febrile seizures. In addition to raising the awareness of an unusual presentation of infection by Saksenaea, this case highlights the importance of pathologic examination for the prompt diagnosis of mucormycosis as well as the specific fungal identification for treatment as Saksenaea spp. may be more susceptible to posaconazole and less susceptible to amphotericin B compared to more common causes of mucormycosis.

摘要

萨克森纳菌属是一种罕见的毛霉病病因,大多数与免疫功能低下和免疫功能正常个体的创伤相关的皮肤和皮下感染有关。与毛霉病的其他病原体不同,大脑感染极为罕见。我们描述了首例 4 岁既往健康男性儿童孤立性大脑感染萨克斯纳菌的病例,该患儿以头痛为主要表现。除了热性惊厥发作外,他没有其他既往病史。除了提高对萨克斯纳菌感染的不常见表现的认识外,该病例还强调了病理检查对快速诊断毛霉病的重要性,以及真菌鉴定的重要性,因为与更常见的毛霉病病因相比,萨克斯纳菌属可能对泊沙康唑更敏感,对两性霉素 B 更不敏感。

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