Document Detail


Cerebral scedosporiosis: an emerging fungal infection in severe neutropenic patients: CT features and CT pathologic correlation.
MedLine Citation:
PMID:  16132929     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Scedosporium prolificans is an emerging opportunistic fungal agent encountered in severely neutropenic patients. The purpose of this paper is to describe the main cranial CT findings from a retrospective review of six patients (four men and two women, 18-66 years old) afflicted with disseminated infection by S. prolificans with neurological symptoms. They were severely neutropenic and presented with severe respiratory failure and conscience deterioration, with a subsequent 100% mortality. The final diagnosis was established by autopsy (performed in five patients) and blood culture findings. Cranial CT showed multiple low-density lesions in four patients without contrast enhancement located in the basal ganglia and corticomedullary junction. Autopsy findings of these lesions demonstrated necrosis and hyphae proliferation inside brain infarcts. Also, two of the patients had a subarachnoid hemorrhage, but angiography could not be performed. CT and autopsy findings were fairly similar to those encountered in cerebral aspergillosis; however, possibly because of its rapid and fatal evolution, no edema or ring enhancing lesions were encountered. Thus, Scedosporium can be included as a rare but possible cause of invasive fungal disseminated central nervous system infections in severely neutropenic patients.
Authors:
Enrique Marco de Lucas; Pablo Sádaba; Pedro Lastra García-Barón; María Luisa Ruiz Delgado; Jorge Cuevas; Ricardo Salesa; Arancha Bermúdez; Andrés González Mandly; Agustín Gutiérrez; Fidel Fernández; Fernando Marco de Lucas; Consuelo Díez
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Publication Detail:
Type:  Journal Article     Date:  2005-08-20
Journal Detail:
Title:  European radiology     Volume:  16     ISSN:  0938-7994     ISO Abbreviation:  Eur Radiol     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-20     Completed Date:  2006-07-06     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  496-502     Citation Subset:  IM    
Affiliation:
Department of Radiology, Hospital Universitario Marqués de Valdecilla, Av. Valdecilla s/n, 39008, Santander, Cantabria, Spain. radmle@humv.es
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Basal Ganglia / pathology
Cerebral Cortex / pathology
Cerebral Infarction / pathology,  radiography
Contrast Media / administration & dosage
Diagnosis, Differential
Female
Humans
Male
Medulla Oblongata / pathology
Meningitis, Fungal / pathology,  radiography*
Middle Aged
Mycetoma / pathology,  radiography*
Necrosis
Neutropenia / diagnosis*,  pathology
Opportunistic Infections / pathology,  radiography*
Prognosis
Respiratory Insufficiency / pathology,  radiography
Scedosporium*
Tomography, X-Ray Computed*
Chemical
Reg. No./Substance:
0/Contrast Media

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