Blastomycosis of the central nervous system: a multicenter review of diagnosis and treatment in the modern era.
Clin Infect Dis
; 50(6): 797-804, 2010 Mar 15.
Article
en En
| MEDLINE
| ID: mdl-20166817
ABSTRACT
BACKGROUND:
Central nervous system (CNS) involvement with Blastomyces dermatitidis is an uncommon and potentially fatal complication of blastomycosis.METHODS:
We retrospectively reviewed 22 patients with CNS blastomycosis at our institutions from 1990 through 2008 (13 proven, 5 probable, and 4 possible cases).RESULTS:
Magnetic resonance imaging was used in most patients, alone or in addition to computed tomography. CNS blastomycosis manifested as epidural abscess (1 of 22), meningitis (7 of 22), intracranial mass lesions (10 of 22), and concomitant intracranial mass lesions and meningitis (4 of 22). All patients received amphotericin B deoxycholate or a lipid formulation of amphotericin B as part of their treatment regimens. Most patients received amphotericin B followed by a prolonged course of oral azole therapy (voriconazole, fluconazole, or itraconazole). Four (18%) of 22 patients died during follow-up.CONCLUSIONS:
On the basis of these data, we recommend initial treatment with a lipid formulation of amphotericin B followed by a prolonged course of oral azole therapy, preferably voriconazole.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Blastomyces
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Blastomicosis
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Infecciones Fúngicas del Sistema Nervioso Central
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Antifúngicos
Tipo de estudio:
Diagnostic_studies
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Observational_studies
Límite:
Adolescent
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Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2010
Tipo del documento:
Article