RESUMEN
Zygomycosis of the central nervous system (CNS) can manifest in three distinct clinical forms, as rhinocerebral zygomycosis, as disseminated zygomycosis with CNS involvement, and as isolated cerebral zygomycosis. We present a case of a 2-year-old boy with leukaemia and disseminated zygomycosis, caused by Absidia corymbifera, involving the brain, spinal cord, lung and liver. The child received treatment with liposomal amphotericin B and posaconazole for 6 months. Although the lesions of the lungs and liver resolved, those of the CNS persisted and the child is in a vegetative state. A review of the literature after 2004 identified ten additional cases of disseminated zygomycosis with cerebral involvement, all but one of which had concurrent lung infection. The most common underlying disease in these cases was haematological malignancy and the mortality rate was 70%. Disseminated zygomycosis with cerebral involvement is a fatal disease. Early recognition and prompt intervention with combined medical and surgical treatment may improve the outcome.
Asunto(s)
Absidia/aislamiento & purificación , Infecciones Fúngicas del Sistema Nervioso Central/diagnóstico , Mucormicosis/complicaciones , Mucormicosis/diagnóstico , Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , Encéfalo/microbiología , Encéfalo/patología , Infecciones Fúngicas del Sistema Nervioso Central/microbiología , Preescolar , Humanos , Hígado/microbiología , Hígado/patología , Pulmón/microbiología , Pulmón/patología , Masculino , Médula Espinal/microbiología , Médula Espinal/patología , Triazoles/uso terapéuticoRESUMEN
CASE: We report a case of a 6-year-old boy with a giant perimedullary arteriovenous fistula of the cervical spine who presented with progressive tetraparesis. METHOD: Transarterial glue embolization was performed and complete occlusion of the fistula was achieved. RESULT: The patient's symptoms resolved completely during the next year.
Asunto(s)
Fístula Arteriovenosa/terapia , Embolización Terapéutica/métodos , Enfermedades Vasculares de la Médula Espinal/terapia , Arteria Vertebral/anomalías , Fístula Arteriovenosa/etiología , Fístula Arteriovenosa/patología , Vértebras Cervicales , Niño , Humanos , Masculino , Cuadriplejía/etiología , Médula Espinal/irrigación sanguínea , Enfermedades Vasculares de la Médula Espinal/complicaciones , Enfermedades Vasculares de la Médula Espinal/patología , Arteria Subclavia/anomalías , Resultado del Tratamiento , Várices/terapiaRESUMEN
Twenty-three children with Langerhans' cell histiocytosis (LCH) have been treated with trimethoprim-sulphamethoxazole (T-S) in a 4-year period. The children are classified in two main groups according to the extent of their disease. Group A includes 16 children with single system disease and group B, seven children with multisystem disease. All patients were treated for 4 weeks to 3 months. The results of treatment are evaluated in terms of response in individual organs involved. All children with single system disease had a good response to the drug. Children with multisystem disease had a good response to some organs but a poorer outcome for the lungs and for the blood. These patients did not respond even to conventional chemotherapy.
