Armonda R A, Fleckenstein J M, Brandvold B, Ondra S L
Department of Neurosurgery, Walter Reed Army Medical Center, Washington, District of Columbia.
Neurosurgery. 1993 Jun;32(6):1034-6; discussion 1036. doi: 10.1227/00006123-199306000-00028.
A case of cryptococcal osteomyelitis of the skull is presented. The patient was an immunocompetent host with skull and skin involvement without central nervous system or pulmonary extension. The radiographic findings are reviewed to include skull films, bone scan, and computed tomographic and magnetic resonance imaging scans. The patient underwent surgical debridement of the lesion as well as systemic medical therapy with amphotericin B and flucytosine. The medical and surgical therapy for such lesions is reviewed. Surgical intervention is emphasized for the removal of bony sequestrum and nonviable bone while maintaining an intact dura.
本文报告一例颅骨隐球菌性骨髓炎病例。患者免疫功能正常,病变累及颅骨和皮肤,未向中枢神经系统或肺部蔓延。回顾了包括颅骨平片、骨扫描、计算机断层扫描和磁共振成像扫描在内的影像学检查结果。患者接受了病变部位的手术清创以及两性霉素B和氟胞嘧啶的全身药物治疗。本文还回顾了此类病变的药物和手术治疗方法。强调手术干预对于清除骨坏死组织和无活力骨的重要性,同时要保持硬脑膜完整。