Rohilla Ranjana, Meena Suneeta, Goyal Nishant, Kaistha Neelam
Department of Microbiology, All India Institute of Medical Science, Rishikesh, Uttarakhand, India.
Department of Laboratory Medicine, AIIMS, Delh.
Curr Med Mycol. 2020 Sep;6(3):69-72. doi: 10.18502/CMM.6.3.4498.
Herein, we describe a rare case of fatal cerebral phaeohyphomycosis by in an immunocompetent individual without any underlying risk factors.
A 55-year-old female presented with a short history of fever for 1 month, as well as headache, sudden onset of right-sided upper and lower limb weakness, and loss of speech for 10 days. Contrast-enhanced magnetic resonance imaging scan revealed large, peripherally enhancing, well-defined, cystic, space- occupying, axial lesion in the left parietal lobe with a mass effect. The patient was subjected to craniotomy, and the drained pus revealed pigmented septate hyphae in potassium hydroxide mount examination, which was identified as . The patient was started on amphotericin B and voriconazole. However, she developed acute respiratory infection leading to multi-organ failure and death on day 27 post-operation.
In the absence of comparative trials owing to the rarity of the disease, the radical resection of lesion, drainage of pus, and prolonged targeted antifungal therapy with close postoperative radiological surveillance are the therapeutic measures of choice for patients with brain abscess caused by phaeoid fungi.
在此，我们描述了一例罕见的免疫功能正常且无任何潜在危险因素的个体发生的致命性脑暗色丝孢霉病病例。
一名55岁女性，有1个月的短期发热病史，以及头痛、突发右侧上下肢无力和失语10天。增强磁共振成像扫描显示左侧顶叶有一个大的、周边强化、边界清晰的囊性占位性轴位病变，并伴有占位效应。患者接受了开颅手术，引流的脓液在氢氧化钾涂片检查中显示有色素分隔菌丝，被鉴定为暗色丝孢霉。患者开始使用两性霉素B和伏立康唑治疗。然而，她在术后第27天发生急性呼吸道感染，导致多器官功能衰竭并死亡。
由于该病罕见，缺乏对照试验，对于由暗色真菌引起的脑脓肿患者，病灶的根治性切除、脓液引流以及术后密切影像学监测下的长期靶向抗真菌治疗是首选的治疗措施。
