CEREBRAL ASPERGILLOSIS IN IMMUNOCOMPROMISED PATIENTS

被引：5

作者：

PRECKEL, MP ^{[1
]}

MERCATELLO, A ^{[1
]}

TOGNET, E ^{[1
]}

DEVAUX, Y ^{[1
]}

ARCHIMBAUD, E ^{[1
]}

FIERE, D ^{[1
]}

MOSKOVTCHENKO, JF ^{[1
]}

机构：

[1] HOP EDOUARD HERRIOT,SERV ANESTHESIE REANIMAT,PAVILLON P,F-69437 LYON 03,FRANCE

来源：

ANNALES FRANCAISES D ANESTHESIE ET DE REANIMATION | 1991年 / 10卷 / 05期

关键词：

D O I：

10.1016/S0750-7658(05)80850-0

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Three cases of central nervous system (CNS) aspergillosis in immunocompromised patients are reported. All three had neurological symptoms with normal cerebrospinal fluid (CSF). The CT scan showed poorly defined low density lesions which were not enhanced by contrast medium. They also had pulmonary signs and fever despite antibiotic treatment. Aspergillus fumigatus was isolated from bronchoalveolar lavage fluid. Antifungal therapy was started promptly, associating amphotericin B, itraconazole and flucytosine. Unfortunately, they died within 2 days to 2 weeks after admission in the intensive care unit. Postmortem examinations revealed disseminated aspergillosis with colonization of brain, lung, heart and kidney. The CT scan signs were quite different from those seen with the more usual bacterial ring lesions. In immunocompromised patients, the agents responsible for producing these findings are Aspergillus, Nocardia, Cryptococcus, Toxoplasma and Mycobacterium tuberculosis. Signs involving organs other than the CNS, and an examination of the CSF, should provide elements for establishing a differential diagnosis. Early antifungal treatment is the only chance of survival. Recrudescent fever and pulmonary signs occurring in neutropaenic patients after antibacterial antibiotic treatment has been started are sufficient criteria for empirically starting amphotericin B administration unless clinical judgement dictates otherwise.

引用

页码：463 / 467

页数：5

共 35 条

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