Meningoencephalitis caused by a zygomycete fungus (Basidiobolus) associated with septic shock in an immunocompetent patient: 1-year follow-up after treatment
Rev. bras. pesqui. méd. biol
; Braz. j. med. biol. res;43(8): 794-798, Aug. 2010. ilus
Article
em En
| LILACS
| ID: lil-554958
Biblioteca responsável:
BR1.1
ABSTRACT
Zygomycosis is an infection caused by opportunistic fungi of the Zygomycetes class, specifically those from the Mucorales and Entomophthorales orders. It is an uncommon disease, mainly restricted to immunocompromised patients. We report a case of a 73-year-old male patient with a history of fever (39°C) lasting for 1 day, accompanied by shivering, trembling, and intense asthenia. The patient was admitted to the intensive care unit with complex partial seizures, and submitted to orotracheal intubation and mechanical ventilation under sedation with midazolam. The electroencephalogram showed evidence of non-convulsive status epilepticus. There is no fast specific laboratory test that permits confirmation of invasive fungal disease. Unless the physician suspects this condition, the disease may progress rapidly while the patient is treated with broad-spectrum antibiotics. Differential diagnosis between fungal and bacterial infection is often difficult. The clinical presentation is sometimes atypical, and etiological investigation is not always successful. In the present case, the histopathological examination of the biopsy obtained from the right temporal lobe indicated the presence of irregular, round, thick-walled fungi forming papillae and elongated structures of irregular diameter, with no septa, indicative of zygomycete (Basidiobolus). Treatment with liposomal amphotericin B and fluconazole was initiated after diagnosis of meningoencephalitis by zygomycete, with a successful outcome.
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Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
3_ND
Base de dados:
LILACS
Assunto principal:
Choque Séptico
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Entomophthorales
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Zigomicose
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Meningoencefalite
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Humans
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Male
Idioma:
En
Revista:
Braz J Med Biol Res
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Braz. j. med. biol. res
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Braz. j. med. biol. res. (Online)
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Brazilian journal of medical and biological research
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Brazilian journal of medical and biological research (Impresso)
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Rev. bras. pesqui. méd. biol
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Revista brasileira de pesquisas médicas e biológicas
Ano de publicação:
2010
Tipo de documento:
Article