PDF(Pubmed)
Abstract：
OBJECTIVE: To report cases of cerebral phaeohyphomycosis at a tertiary hospital in Riyadh, Saudi Arabia. Phaeohyphomycetes are a widely distributed group of fungi whose cell walls contain 1,8 dihydroxynaphthalene-melanin. Cerebral infections caused by these fungi are uncommon and primarily associated with neurotrophic phaeohyphomycetes.
METHODS: In January of 2020 we looked back to identify cases of culture-positive cerebral phaeohyphomycosis from our medical records at King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia. Data on demographics, potential risk factors, clinical presentation, treatment, and outcomes were analyzed.
RESULTS: Twelve cases of cerebral phaeohyphomycosis were identified, of which 4 were caused by Rhinocladiella mackenziei and the other 8 were caused by various phaeohyphomycetes. There were 2 cases caused by Neoscytalidium dimidiatum, and one case each caused by the following: Acrophialophora fusispora, Chaetomium atrobrunneum, Exophiala dermatitidis, Exerohilum rostratum, Fonsecaea pedrosoi, and Cladophialophora bantiana. Most patients (10 of 12) had underlying immunosuppression. R. mackenziei caused a brain-only infection manifesting as abscess formation. Four patients survived for more than a year after therapy. Surgical evacuation and triazole therapy with posaconazole or itraconazole, alone or in combination with other antifungal agents, were associated with success.
CONCLUSIONS: Cerebral phaeohyphomycosis is an uncommon fungal infection that primarily affects immunocompromised patients and is associated with poor prognosis. R. mackenziei is the most prevalent fungus in our facility and has been linked to a universal mortality.
METHODS: In January of 2020 we looked back to identify cases of culture-positive cerebral phaeohyphomycosis from our medical records at King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia. Data on demographics, potential risk factors, clinical presentation, treatment, and outcomes were analyzed.
RESULTS: Twelve cases of cerebral phaeohyphomycosis were identified, of which 4 were caused by Rhinocladiella mackenziei and the other 8 were caused by various phaeohyphomycetes. There were 2 cases caused by Neoscytalidium dimidiatum, and one case each caused by the following: Acrophialophora fusispora, Chaetomium atrobrunneum, Exophiala dermatitidis, Exerohilum rostratum, Fonsecaea pedrosoi, and Cladophialophora bantiana. Most patients (10 of 12) had underlying immunosuppression. R. mackenziei caused a brain-only infection manifesting as abscess formation. Four patients survived for more than a year after therapy. Surgical evacuation and triazole therapy with posaconazole or itraconazole, alone or in combination with other antifungal agents, were associated with success.
CONCLUSIONS: Cerebral phaeohyphomycosis is an uncommon fungal infection that primarily affects immunocompromised patients and is associated with poor prognosis. R. mackenziei is the most prevalent fungus in our facility and has been linked to a universal mortality.
摘要：
目的：报告利雅得一家三级医院的脑型真菌病病例，沙特阿拉伯。孢霉菌是一类分布广泛的真菌，其细胞壁含有1,8二羟基萘-黑色素。由这些真菌引起的脑部感染并不常见，主要与神经营养性细菌有关。
方法：在2020年1月，我们回顾了在利雅得费萨尔国王专科医院和研究中心的医疗记录中发现的培养阳性脑型真菌病病例，沙特阿拉伯。人口统计数据，潜在风险因素，临床表现,治疗,并对结果进行了分析。
结果：确定了12例脑带真菌病，其中4个是由麦肯齐氏杆菌引起的，另外8个是由各种斑孢菌引起的。2例由双盲性心梗引起，由以下各例引起的一种情况：品藻，阿特布伦毛虫，皮肤外植体,Exeroilumrostratum,Fonsecaeapedrosoi,还有念珠菌.大多数患者（12人中有10人）具有潜在的免疫抑制。R.mackenziei引起的仅脑部感染，表现为脓肿形成。四名患者在治疗后存活了一年以上。泊沙康唑或伊曲康唑的外科疏散和三唑治疗，单独或与其他抗真菌剂联合使用，与成功有关。
结论：脑型真菌病是一种罕见的真菌感染，主要影响免疫功能低下患者，并与不良预后相关。R.mackenziei是我们设施中最普遍的真菌，并与普遍死亡率有关。
方法：在2020年1月，我们回顾了在利雅得费萨尔国王专科医院和研究中心的医疗记录中发现的培养阳性脑型真菌病病例，沙特阿拉伯。人口统计数据，潜在风险因素，临床表现,治疗,并对结果进行了分析。
结果：确定了12例脑带真菌病，其中4个是由麦肯齐氏杆菌引起的，另外8个是由各种斑孢菌引起的。2例由双盲性心梗引起，由以下各例引起的一种情况：品藻，阿特布伦毛虫，皮肤外植体,Exeroilumrostratum,Fonsecaeapedrosoi,还有念珠菌.大多数患者（12人中有10人）具有潜在的免疫抑制。R.mackenziei引起的仅脑部感染，表现为脓肿形成。四名患者在治疗后存活了一年以上。泊沙康唑或伊曲康唑的外科疏散和三唑治疗，单独或与其他抗真菌剂联合使用，与成功有关。
结论：脑型真菌病是一种罕见的真菌感染，主要影响免疫功能低下患者，并与不良预后相关。R.mackenziei是我们设施中最普遍的真菌，并与普遍死亡率有关。
