RESUMO
AIMS: To describe the pathology of central nervous system (CNS) fungal infections with particular reference to India. METHODS AND RESULTS: This was a retrospective study from 1988 to 2004 constituting 130 cases. The diagnosis was based on morphology of biopsy/autopsy material. These included aspergillosis (n=73), zygomycosis (n=40), cryptococcosis (n=2), rhodotorulosis (n=1), candidiasis (n=5), maduramycosis (n=1), pheohyphomycosis (n=3) and mixed infections (n=5). Predisposing risk factors were present in 49 (38%) patients only. The majority of the patients were immunocompetent. The commonest risk factor was diabetes mellitus, the commonest route of infection was from a contiguous site and the commonest pathology was granuloma. Culture positivity was seen in only 31%. CONCLUSION: Environmental factors in tropical countries such as India play a significant role in the pathogenesis of CNS fungal infections.
Assuntos
Infecções Fúngicas do Sistema Nervoso Central/patologia , Adolescente , Adulto , Idoso , Infecções Fúngicas do Sistema Nervoso Central/epidemiologia , Criança , Pré-Escolar , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/microbiologia , Diabetes Mellitus/patologia , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de RiscoRESUMO
OBJECTIVE: To report three patients with isolated Rosai Dorfman disease of the central nervous system. CASE REPORTS: We report two patients with dural-based lesions diagnosed imageologically as meningiomas, and one patient with multiple intraparenchymal lesions diagnosed imageologically as lymphoma. Two patients were males and one was female. All were above 35 years of age with no nodal or other system involvement. The diagnosis was established on surgically excised masses during histopathology. One patient died due to unrelated causes 10 years later and the other two are symptom-free at 21.5- and 11.5-year-follow-up. CONCLUSIONS: Awareness of the entity and consideration in the differential diagnosis of dural-based/intraparenchymal lesions is necessary for diagnosis and prognosis.
Assuntos
Encefalopatias/patologia , Encéfalo/patologia , Dura-Máter/patologia , Histiocitose Sinusal/patologia , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Encefalopatias/diagnóstico por imagem , Encefalopatias/fisiopatologia , Diagnóstico Diferencial , Dura-Máter/diagnóstico por imagem , Dura-Máter/fisiopatologia , Feminino , Histiócitos/imunologia , Histiócitos/patologia , Histiocitose Sinusal/diagnóstico por imagem , Histiocitose Sinusal/fisiopatologia , Humanos , Tolerância Imunológica/imunologia , Linfoma/diagnóstico , Macrófagos/imunologia , Macrófagos/patologia , Imageamento por Ressonância Magnética , Masculino , Meningioma/diagnóstico , Pessoa de Meia-Idade , Fibras Nervosas Mielinizadas/patologia , Prognóstico , Proteínas S100/metabolismo , Tomografia Computadorizada por Raios XRESUMO
Five patients with central nervous system actinomycosis are presented. There were risk factors in 2 patients like penetrating head injury and tetralogy of Fallot. All the cases were diagnosed by histopathology. Four patients recovered after surgery and antibiotic therapy, and 1 patient died.
Assuntos
Actinomicose/patologia , Abscesso Encefálico/microbiologia , Abscesso Encefálico/patologia , Encéfalo/microbiologia , Osteomielite/patologia , Actinomicose/cirurgia , Adolescente , Adulto , Encéfalo/patologia , Abscesso Encefálico/cirurgia , Traumatismos Craniocerebrais/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteomielite/cirurgia , Fatores de Risco , Crânio/patologia , Crânio/cirurgia , Resultado do TratamentoRESUMO
A 22 years male patient presented with recurrent seizures, CT and MRI diagnosis of tuberculoma was made and the patient was treated. When seizures persisted, a craniotomy was done and the excised mass revealed an abscess with a segment of broad solid non-cavitory body, wall with no scolex and loose stroma and smooth muscle fibers. A diagnosis of sparganosis cerebral abscess was made. The case is reported in view of the rarity of cerebral sparganosis in India and the need for awareness of the entity in India.
