CNS ASPERGILLOSIS IN ORGAN-TRANSPLANTATION - A CLINICOPATHOLOGICAL STUDY

被引:94
作者
TORRECISNEROS, J
LOPEZ, OL
KUSNE, S
MARTINEZ, AJ
STARZL, TE
SIMMONS, RL
MARTIN, M
机构
[1] UNIV PITTSBURGH,PRESBYTERIAN HOSP,SCH MED,DEPT SURG,PITTSBURGH,PA 15260
[2] UNIV PITTSBURGH,PRESBYTERIAN HOSP,SCH MED,DEPT NEUROL,PITTSBURGH,PA 15260
[3] UNIV PITTSBURGH,PRESBYTERIAN HOSP,SCH MED,DEPT MED,PITTSBURGH,PA 15260
[4] UNIV PITTSBURGH,PRESBYTERIAN HOSP,SCH MED,DEPT PATHOL NEUROPATHOL,PITTSBURGH,PA 15260
关键词
D O I
10.1136/jnnp.56.2.188
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The clinical characteristics and neuropathological findings of 22 organ transplant recipients with CNS aspergillosis were reviewed. Thirteen patients had liver, six kidney, two heart and one had cluster transplants. The most frequent neurological symptoms were alteration of mental status (86%), seizures (41%) and focal neurological deficits (32%). Meningeal signs were less common (19%). Aspergillus spp invasion of the blood vessels with subsequent ischaemic or haemorrhagic infarcts, and solitary or multiple abscesses were the predominant neuropathological findings. The lungs were the probable portal of entry; however, isolated CNS aspergillosis was seen in two patients. Antemortem diagnosis of the infection was made in half of the patients. Concomitant diabetes mellitus was noted in 59% of the patients and bacterial or other severe infections in 86%. No specific clinical or pathological pattern could be identified among patients with different types of organ transplants. In addition CNS aspergillosis was preceded by organ rejection and the need for intense immunosuppression and retransplantation in the majority of the patients.
引用
收藏
页码:188 / 193
页数:6
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