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免疫功能正常患者继发于脑曲霉菌病伴脑室炎的上矢状窦血栓形成:一例报告

Superior Sagittal Sinus Thrombosis Secondary to Cerebral Aspergillosis with Ventriculitis in an Immunocompetent Patient: A Case Report.

作者信息

Chaisawasthomrong Chonnawee

机构信息

Division of Neurosurgery, Department of Surgery, Ratchaburi Hospital, Ratchaburi, Thailand.

出版信息

Asian J Neurosurg. 2024 Oct 10;20(1):160-164. doi: 10.1055/s-0044-1791714. eCollection 2025 Mar.

Abstract

Cerebral aspergillosis is an opportunistic fungal infection that is exceedingly rare in immunocompetent patients. The primary etiological locations for these infections typically involve the nasal cavity and hematological dissemination. A 62-year-old male, focused on wellness, presented with intermittent, nonprogressive headaches in the occipital region, generalized clonic-tonic seizures, and altered consciousness. A computed tomography scan revealed multiple small rim-enhancing lesions in both occipital lobes, with vasogenic edema in both occipital lobes adjacent to the confluence of the sinuses and the posterior superior sagittal sinus. In this case, superior sagittal sinus thrombosis secondary to cerebral aspergillosis was discovered, a condition not previously diagnosed in this specific location but manageable through surgical intervention. A combination of surgical resection and antifungal therapy resulted in favorable outcomes. The prognosis for patients depends significantly on early diagnosis and prompt, aggressive treatment.

摘要

脑曲霉病是一种机会性真菌感染,在免疫功能正常的患者中极为罕见。这些感染的主要病因部位通常涉及鼻腔和血液播散。一名关注健康的62岁男性,出现枕部间歇性、非进行性头痛、全身性阵挛-强直发作和意识改变。计算机断层扫描显示双侧枕叶有多个小的环形强化病灶,双侧枕叶与鼻窦和上矢状窦后部汇合处相邻出现血管源性水肿。在该病例中,发现了继发于脑曲霉病的上矢状窦血栓形成,这种情况以前在这个特定部位未被诊断出来,但可通过手术干预进行治疗。手术切除和抗真菌治疗相结合产生了良好的效果。患者的预后很大程度上取决于早期诊断以及及时、积极的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6513/11875696/74381fe49206/10-1055-s-0044-1791714-i2410012-1.jpg

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