Morton S J, Midthun K, Merz W G
Arch Pathol Lab Med. 1986 Dec;110(12):1183-5.
We describe a case of granulomatous encephalitis caused by Bipolaris (Drechslera) hawaiiensis in an immunocompetent patient. An 18-year-old man with a seven-month history of seizures and right leg weakness was found by computed tomographic scan to have a left frontoparietal enhancing lesion. Biopsy of the lesion revealed granulomatous inflammation and numerous septate hyphae. Culture of the biopsy specimen yielded a pure culture of B hawaiiensis in four days. Susceptibility studies revealed the organism to be sensitive to amphotericin B (minimal inhibitory concentration [MIC] equals 0.25 mg/L) and miconazole lactate (MIC equals 0.064 mg/L), but resistant to flucytosine (MIC greater than 100 mg/L). No synergy was demonstrated with amphotericin B and flucytosine in vitro. The patient was successfully treated with surgery and systemic and intrathecal amphotericin B therapy, and a negative culture was obtained from a repeated brain biopsy six weeks later.
我们报告一例免疫功能正常患者由夏威夷双极霉（德氏霉属）引起的肉芽肿性脑炎。一名18岁男性，有7个月癫痫发作和右腿无力病史，计算机断层扫描发现左额顶叶有强化病变。病变活检显示肉芽肿性炎症和大量分隔菌丝。活检标本培养4天后获得夏威夷双极霉纯培养物。药敏研究显示该菌对两性霉素B（最低抑菌浓度[MIC]等于0.25mg/L）和乳酸咪康唑（MIC等于0.064mg/L）敏感，但对氟胞嘧啶耐药（MIC大于100mg/L）。体外试验未显示两性霉素B和氟胞嘧啶有协同作用。该患者接受手术及全身和鞘内两性霉素B治疗后成功治愈，6周后重复脑活检培养结果为阴性。
