<i>Petriellidium boydii</i>Infection of the Sphenoid Sinus

Bryan, Charles S.; DiSalvo, Arthur F.; Kaufman, Leo; Kaplan, William E.; Brill, Alan H.; Abbott, Don C.

doi:10.1093/ajcp/74.6.846

Cited by 44 publications

(18 citation statements)

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“…After this, further 98 cases have been described. Of those, 96 were detailed individually, 4–6,14–90 and three were summarised in general reports on CNS aspergillosis, 91 brain abscesses following marrow transplantation, 92 and treatment of central nervous system fungal infections 93 . Recurrence of CNS infection was documented in one case 15 .…”

Section: Resultsmentioning

confidence: 99%

Central nervous system infections by members of the Pseudallescheria boydii species complex in healthy and immunocompromised hosts: epidemiology, clinical characteristics and outcome

Kantarcıoğlu¹,

Guarro

Hoog

2008

Mycoses

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Infections caused by members of the Pseudallescheria boydii species complex are currently among the most common mould infections. These fungi show a particular tropism for the central nervous system (CNS). We reviewed all the available reports on CNS infections, focusing on the geographical distribution, infection routes, immunity status of infected individuals, type and location of infections, clinical manifestations, treatment and outcome. A total of 99 case reports were identified, with similar percentage of healthy and immunocompromised patients (44% vs. 56%; P = 0.26). Main clinical types were brain abscess (69%), co-infection of brain tissue and/or spinal cord with meninges (10%) and meningitis (9%). The mortality rate was 74%, regardless of the patient's immune status, or the infection type and/or location. Cerebrospinal fluid culture was revealed as a not very important tool as the percentage of positive samples for P. boydii complex was not different from that of negative ones (67% vs. 33%; P = 0.10). In immunocompetent patients, CNS infection was preceded by near drowning or trauma. In these patients, the infection was characterised by localised involvement and a high fatality rate (76%). In contrast, CNS infection in immunocompromised patients was presented as rapidly progressive disseminated lesions at various degrees of evolution. Major risk factors for CNS infection were the aspiration of polluted water in near-drowning episodes in immunologically intact patients and medical immunosuppression in the remaining patient groups. As the therapeutic options were poor, the treatment was difficult in general and the prognosis was poor.

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Section: Resultsmentioning

confidence: 99%

Central nervous system infections by members of the Pseudallescheria boydii species complex in healthy and immunocompromised hosts: epidemiology, clinical characteristics and outcome

Kantarcıoğlu¹,

Guarro

Hoog

2008

Mycoses

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“…P. boydii may get access to the CNS in at least four different ways: by direct inoculation from trauma (329); by hematogenous dissemination from a pulmonary source, including aspiration into the lungs, after a near-drowning experience (131); via an intravenous (i.v.) catheter (487); and via direct extension from infected paranasal sinuses (56).…”

Section: Pulmonary and Disseminated Diseasementioning

confidence: 99%

Infections Caused byScedosporiumspp

et al. 2008

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SUMMARY Scedosporium spp. are increasingly recognized as causes of resistant life-threatening infections in immunocompromised patients. Scedosporium spp. also cause a wide spectrum of conditions, including mycetoma, saprobic involvement and colonization of the airways, sinopulmonary infections, extrapulmonary localized infections, and disseminated infections. Invasive scedosporium infections are also associated with central nervous infection following near-drowning accidents. The most common sites of infection are the lungs, sinuses, bones, joints, eyes, and brain. Scedosporium apiospermum and Scedosporium prolificans are the two principal medically important species of this genus. Pseudallescheria boydii, the teleomorph of S. apiospermum, is recognized by the presence of cleistothecia. Recent advances in molecular taxonomy have advanced the understanding of the genus Scedosporium and have demonstrated a wider range of species than heretofore recognized. Studies of the pathogenesis of and immune response to Scedosporium spp. underscore the importance of innate host defenses in protection against these organisms. Microbiological diagnosis of Scedosporium spp. currently depends upon culture and morphological characterization. Molecular tools for clinical microbiological detection of Scedosporium spp. are currently investigational. Infections caused by S. apiospermum and P. boydii in patients and animals may respond to antifungal triazoles. By comparison, infections caused by S. prolificans seldom respond to medical therapy alone. Surgery and reversal of immunosuppression may be the only effective therapeutic options for infections caused by S. prolificans.

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“…A paranasal sinus mycetoma was described in a 92-year-old patient [207]. In otherwise healthy patients the bony margin of the sinus is invaded or extension into contiguous brain is noted, causing a purulent abscess in the frontal lobe [74,208,209]. The process may evolve for weeks without fever and with little pain.…”

Section: Characteristics Of Diseasementioning

confidence: 99%