Izumiya Ryou, Fujita Yasuhiko, Amagai Teruyoshi
Department of Medicine, Tokunoshima Tokushukai General Hospital, Kagoshima, Japan.
Faculty of Health Care Sciences, Department of Clinical Engineering, Jikei University of Health Care Sciences, Osaka, Japan.
Radiol Case Rep. 2021 Nov 26;17(2):326-331. doi: 10.1016/j.radcr.2021.10.031. eCollection 2022 Feb.
An invasive aspergillosis (IA) primarily occurs among immunocompromised patients. Recently with an influenzae infection prevalently spreading, influenzae-associated invasive aspergillosis (IAIA) has been reported occasionally. By contrast, neuroleptic malignant syndrome (NMS) occurs rarely in psychiatric patients who are treated with Olanzapine. We report a 43 years old male with psychiatric disorder who had developed IAIA followed by NMS and cerebral hemorrhage as the result of aspergillus invasion to cerebral vessels. He had also super-infection of COVID-19, 13 months later to be saved completely after invasive mechanical respiratory supports. From clinical aspects, we would emphasize that it is of importance to find earlier co-occurrence of IAIA patients with cerebral hemorrhage due to secondary infectious vasculopathy of IA.
侵袭性曲霉病（IA）主要发生在免疫功能低下的患者中。最近，随着流感感染的普遍传播，偶尔有流感相关侵袭性曲霉病（IAIA）的报道。相比之下，在接受奥氮平治疗的精神科患者中，神经阻滞剂恶性综合征（NMS）很少发生。我们报告了一名43岁患有精神疾病的男性，他因曲霉侵袭脑血管而先后发生IAIA、NMS和脑出血。他还合并了COVID-19感染，13个月后在有创机械通气支持下完全康复。从临床角度来看，我们强调重要的是要更早发现IAIA患者因IA继发性感染性血管病变而并发脑出血的情况。
