Letscher V, Herbrecht R, Gaudias J, Taglang G, Koenig H, Dupuis M G, Waller J
Institut de Parasitologie et de Pathologie Tropicale, Strasbourg, France.
J Med Vet Mycol. 1997 Jul-Aug;35(4):279-82.
We report an intracranial epidural abscess caused by Aspergillus fumigatus in an immunocompetent patient. Infection occurred in a 20-year-old man 2 months after a frontal craniotomy following trauma. The abscess was encapsulated by a thickened dura and although the fungus did not invade the brain, frontal bone was infected and the patient presented with a subcutaneous frontal cellulitis. Initial management combined surgical drainage, resection of necrotic bone and liposomal amphotericin B (1 mg kg-1 per day). After 3 weeks of antifungal treatment a second evaluation surgery was performed. A clinically and radiologically unsuspected new abscess was found and evacuated. Treatment was completed with instillation into the cavity of amphotericin B at a concentration of 5 mg ml-1 and prolonged oral itraconazole (400-600 mg day-1). Treatment was successful and the patient is free of infection after 3 years.
我们报告了一例免疫功能正常的患者发生的由烟曲霉引起的颅内硬膜外脓肿。感染发生在一名20岁男性患者身上，该患者在创伤后进行额部开颅手术2个月后发病。脓肿被增厚的硬脑膜包裹，尽管真菌未侵入脑实质，但额骨受到感染，患者出现额部皮下蜂窝织炎。初始治疗包括手术引流、切除坏死骨以及脂质体两性霉素B（每日1mg/kg）。抗真菌治疗3周后进行了第二次评估手术，发现并清除了一个临床和影像学检查均未怀疑的新脓肿。通过向脓腔内滴注浓度为5mg/ml的两性霉素B以及长期口服伊曲康唑（每日400 - 600mg）完成治疗。治疗成功，患者3年后无感染迹象。
