Intracranial fungal granuloma

Sharma, Bhawani S.; Khosla, Virender K.; Vk, Kak; Banerjee, A K; Vasishtha, Rakesh Kumar; Prasad, K. S. Manjunath; Sharma, Subhash C.; Mathuriya, S. N.; Mk, Tewari; Pathak, Ashish

doi:10.1016/s0090-3019(96)00209-1

Cited by 59 publications

(77 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2,24) Aspergillus can invade the cranium through three major routes: seeding via the circulatory system from a distant site such as the lung; direct invasion through a wound or surgical incision; and local extension from the paranasal sinuses, orbit, or middle ear. 17,19) In general, most cases of intracranial aspergillosis are considered to occur through the circulatory system, particularly in immunosuppressed patients.…”

Section: Discussionmentioning

confidence: 99%

Local Administration of Amphotericin B Against Aspergilloma in the Prepontine Cistern-Case Report-

Nabika

Kiya

Satoh

et al. 2007

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

A 21-year-old man presented with aspergilloma in the prepontine cistern that developed after treatment for cerebellar hematoma following rupture of an arteriovenous malformation. He became bedridden with neurological signs of tetraparesis, disturbed ocular movement, and bulbar palsy, despite alert consciousness. Repeat magnetic resonance imaging 1 year later revealed a space-occupying lesion in the prepontine cistern along the clivus. This multilobular enhanced mass lesion gradually enlarged towards the brainstem over the following 4 years, resulting in loss of spontaneous breathing and dependence on a mechanical respirator. Surgical treatment via a lateral suboccipital approach was selected to reduce the size of the mass lesion and confirm the diagnosis. Histological examination revealed the presence of Aspergillus fumigatus. Treatment with amphotericin B (1 mg/kg/day) and fluconazole (100 mg/kg/day) injected into the peripheral veins was initiated, but was stopped due to the appearance of renal dysfunction. An Ommaya tube was then inserted into the prepontine cistern via a transsylvian approach to provide high concentrations of amphotericin B around the granulomatous lesion. He gradually improved, corresponding to the decreased size of the aspergilloma just after surgery. Surgical reduction of granuloma combined with local administration of antifungal agent is a good treatment option in patients with aspergilloma refractory to systemic administration.

show abstract

Section: Discussionmentioning

confidence: 99%

Local Administration of Amphotericin B Against Aspergilloma in the Prepontine Cistern-Case Report-

Nabika

Kiya

Satoh

et al. 2007

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

show abstract

“…In our opinion, his poor prognosis was attributed to his elder age, longtime course, and the widespread infection caused by the rapid progression in size and number of lesions. Based on the literature, [7][8][9] we propose that diagnosing the disease based on radiologic or pathologic findings in the early stage, starting combined antifungal therapies, and even performing surgical treatment if necessary could possibly improve the prognosis of patients with CNS aspergillosis.…”

Section: Discussionmentioning

confidence: 99%

Invasive intracranial aspergillosis spread by the pterygopalatine fossa in an immunocompetent patient

Xiao¹,

Jiang²,

Liu³

et al. 2012

Braz J Infect Dis

View full text Add to dashboard Cite

Pterygopalatine fossa Magnetic resonance imaging A B S T R A C T Aspergillosis of the central nervous system (CNS) is an uncommon infection, mainly found inimmunocompromised patients but rarely seen among immunocompetent patients. Herein we describe a 57 year-old immunocompetent man who suffered intracranial aspergillosis spread by the pterygopalatine fossa (PPF) following a tooth extraction. Based on magnetic resonance imaging (MRI) characteristics, in this report we focus on the spreading routes of CNS aspergillosis via communicative structures of the PPF, the relationship between clinical manifestations and the locations of the lesion, and propose a therapeutic strategy to improve the prognosis.© 2012 Elsevier Editora Ltda. All rights reserved. Case presentationA 57-year-old male had suffered from persistent headache for 20 months on the left occipitotemporal side after a tooth extraction, followed by a decrease of his left visual acuity and disordered speech. On neurological examinations, his left eye fixed with light reflex disappeared, the ipsilateral palpebral fissure became narrow in response to his eyelid weakness, and the temporalis and masseter muscles were weak with apparent atrophy. Moreover, his left side hearing declined, his left face felt numb, and his memory deteriorated. On magnetic resonance imaging (MRI) of the head, an enlarged mass with hypo-intense signal on T2WI and T1WI in the left pterygopalatine fossa (PPF) was shown, involving the ipsilateral sphenoid sinus, cavernous sinus, inferior orbital fissure, and temporal and frontal lobes. The left pterygopalatine canal was obviously enlarged with abnormal signal intensity. The contrast enhanced T1WI showed strong enhancement at the aforementioned regions (Fig. 1). In order to confirm the nature of the mass, a transnasal biopsy of the PPF was carried out. The histological result revealed the rare finding of Aspergillus. Antifungal therapy was immediately started with vorionazole and amphotericin B. However, his condition was not satisfactorily under control after a long period of antibiotic therapy. A surgical operation was then arranged, and preoperation examinations were completed. The patient underwent a left pterion craniotomy with resection of skull base occupying lesions. The multiple intradural lesions were excised, and Aspergillus was proved again by intraoperative biopsy. The lesion had a light yellowish color and a hard consistency that was tightly adhered to the nearby tissue, especially to the left middle cerebral artery. After incision, the

show abstract

“…Although, any age groups are equally susceptible to fungal infections, there is a mild preponderance in the third and fourth decade [1, 3]. The differences between pediatric and adult cerebral aspergillosis may be realized in a larger study in which multiple related factors could be compared.…”

Section: Discussionmentioning

confidence: 99%

“…Although fungal infections of the central nervous system (CNS) are being diagnosed with increasing frequency, intracranial fungal granulomas are an uncommon entity [1], particularly in children. Aspergillus is the commonest fungus to cause intracerebral granuloma formation, but their occurrence is less frequent than the chronic invasive form of paranasal sinus aspergillosis [2].…”

Section: Introductionmentioning

confidence: 99%

Cerebral Aspergillosis in Children

Cuccia¹,

Galarza²,

Monges³

2000

Pediatr Neurosurg

View full text Add to dashboard Cite

Between March and December of 1997, 3 cases of infantile cerebral aspergillosis appeared in our hospital. All patients presented some kind of immunosuppression associated with clinical findings of intracranial hypertension. After surgery, all cases were histopathologically confirmed and had positive cultures of Aspergillus. The first case was a patient with a history of subtotal resection of supratentorial ependymoma which presented a new enhancing mass on a control CT scan. Brain tumor recidiva was suspected, although, an Aspergillus granuloma was encountered on the tumor bed. Both other cases were found in patients who underwent transplantation: one presented multiple cerebral lesions after a renal transplant, and the other, after a bone marrow transplant, developed a rhinocerebral aspergillosis. The discussion was focused on the clinical findings, images and treatment of this cerebral infectious disease.

show abstract

Intracranial fungal granuloma

Cited by 59 publications

References 60 publications

Local Administration of Amphotericin B Against Aspergilloma in the Prepontine Cistern-Case Report-

Local Administration of Amphotericin B Against Aspergilloma in the Prepontine Cistern-Case Report-

Invasive intracranial aspergillosis spread by the pterygopalatine fossa in an immunocompetent patient

Cerebral Aspergillosis in Children

Contact Info

Product

Resources

About