Diffuse Myelitis after Treatment of Cerebral Aspergillosis in an Immune Competent Patient

Presentation of an unusual case of cerebral aspergillosis in an immune competent patient who was treated successfully but symptoms and signs of a demyelinating process following initial recovery has been occurred. A 29-year-old male with focal seizure. Brain MRI revealed small multiple hemispheric a...

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Main Authors: Reza Mollahoseini, Mahdi Nikoobakht
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2011-06-01
Series:Acta Medica Iranica
Subjects:
Online Access:http://journals.tums.ac.ir/upload_files/pdf/18932.pdf
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author Reza Mollahoseini
Mahdi Nikoobakht
author_facet Reza Mollahoseini
Mahdi Nikoobakht
author_sort Reza Mollahoseini
collection DOAJ
description Presentation of an unusual case of cerebral aspergillosis in an immune competent patient who was treated successfully but symptoms and signs of a demyelinating process following initial recovery has been occurred. A 29-year-old male with focal seizure. Brain MRI revealed small multiple hemispheric and dural lesions. An open biopsy was conducted. Histological evaluation revealed hyphe-like structure in the necrotic area, within vessel walls, and lumina, suggestive aspergillus fumigatus . Furthermore, brancheal hyphae in potassium hydrxide15% and colonies on sabourud dextrose agar were observed. Based of the above findings the patient underwent anti fungal therapy. The patient recovered and continued a normal life however a follow up MRI was performed after 3 months from recovery. No significant abnormality was observed from the MRI procedure. One month later the patient developed signs and symptoms of spinal cord involvement which seemed to be the result of myelitis. A brain MR showed no abnormalities .Therefore it seemed reasonable to administer corticosteroid as a treatment for suspected active demyelinating process. During the above treatment, signs and symptoms of myelopathy disappeared and a whole spine MRI showed remarkable improvement.
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spelling doaj.art-2b40dfba145c42dfbd1f8225ea8bbc1e2022-12-21T20:56:19ZengTehran University of Medical SciencesActa Medica Iranica0044-60252011-06-01496402406Diffuse Myelitis after Treatment of Cerebral Aspergillosis in an Immune Competent PatientReza MollahoseiniMahdi NikoobakhtPresentation of an unusual case of cerebral aspergillosis in an immune competent patient who was treated successfully but symptoms and signs of a demyelinating process following initial recovery has been occurred. A 29-year-old male with focal seizure. Brain MRI revealed small multiple hemispheric and dural lesions. An open biopsy was conducted. Histological evaluation revealed hyphe-like structure in the necrotic area, within vessel walls, and lumina, suggestive aspergillus fumigatus . Furthermore, brancheal hyphae in potassium hydrxide15% and colonies on sabourud dextrose agar were observed. Based of the above findings the patient underwent anti fungal therapy. The patient recovered and continued a normal life however a follow up MRI was performed after 3 months from recovery. No significant abnormality was observed from the MRI procedure. One month later the patient developed signs and symptoms of spinal cord involvement which seemed to be the result of myelitis. A brain MR showed no abnormalities .Therefore it seemed reasonable to administer corticosteroid as a treatment for suspected active demyelinating process. During the above treatment, signs and symptoms of myelopathy disappeared and a whole spine MRI showed remarkable improvement.http://journals.tums.ac.ir/upload_files/pdf/18932.pdfAspergillus fumigatesAspergillosisMyelitis
spellingShingle Reza Mollahoseini
Mahdi Nikoobakht
Diffuse Myelitis after Treatment of Cerebral Aspergillosis in an Immune Competent Patient
Acta Medica Iranica
Aspergillus fumigates
Aspergillosis
Myelitis
title Diffuse Myelitis after Treatment of Cerebral Aspergillosis in an Immune Competent Patient
title_full Diffuse Myelitis after Treatment of Cerebral Aspergillosis in an Immune Competent Patient
title_fullStr Diffuse Myelitis after Treatment of Cerebral Aspergillosis in an Immune Competent Patient
title_full_unstemmed Diffuse Myelitis after Treatment of Cerebral Aspergillosis in an Immune Competent Patient
title_short Diffuse Myelitis after Treatment of Cerebral Aspergillosis in an Immune Competent Patient
title_sort diffuse myelitis after treatment of cerebral aspergillosis in an immune competent patient
topic Aspergillus fumigates
Aspergillosis
Myelitis
url http://journals.tums.ac.ir/upload_files/pdf/18932.pdf
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