Ruptured fungal aneurysm of the peripheral middle cerebral artery caused by Lomentospora infection: A case report and literature review
Background: Infection of Lomentospora (Scedosporium) spp. is very rare but high mortality. Above all, a fungal aneurysm due to Lomentospora spp. is extremely rare. The prognosis of ruptured fungal aneurysm due to Lomentospora spp. is remarkably poor in spite of proper surgical treatment and chemothe...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-09-01
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| Series: | Interdisciplinary Neurosurgery |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751920300414 |
| _version_ | 1811223442992660480 |
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| author | Sho Takata Akira Tamase Yasuhiko Hayashi Kazushi Anzawa Akihiro Shioya Yoshitsugu Iinuma Hideaki Iizuka |
| author_facet | Sho Takata Akira Tamase Yasuhiko Hayashi Kazushi Anzawa Akihiro Shioya Yoshitsugu Iinuma Hideaki Iizuka |
| author_sort | Sho Takata |
| collection | DOAJ |
| description | Background: Infection of Lomentospora (Scedosporium) spp. is very rare but high mortality. Above all, a fungal aneurysm due to Lomentospora spp. is extremely rare. The prognosis of ruptured fungal aneurysm due to Lomentospora spp. is remarkably poor in spite of proper surgical treatment and chemotherapy. Case Description: A 70-year-old female who was having chemotherapy for acute myeloid leukemia suffered from a sudden onset of severe consciousness disturbance. A brain computed tomography (CT) scan revealed large hematoma at the right parietal lobe adjacent to subdural hematoma with a slight subarachnoid hemorrhage. Three dimensional-CT angiography showed an intracranial aneurysm at the right peripheral portion of the middle cerebral artery. Surgical clipping and resection of the aneurysm were successfully performed on the same day. Lomentospora prolificans was identified on the blood culture, and pathological examination of the aneurysmal wall recognized fungus body and hypha. Voriconazole (VRCZ) was administered immediately. However, she died of multiple organ failure 14 days after surgery. Conclusion: In all previously reported cases, fungal aneurysm after a Lomentospora infection led to miserable sequelae even if the aneurysm was properly treated, and VRCZ was administrated. The peripheral portion of the aneurysm due to lomentosporiosis has never been reported. Hematogenous transmission was suggested as a possible developing mechanism. |
| first_indexed | 2024-04-12T08:33:04Z |
| format | Article |
| id | doaj.art-8c5f49c05fbb41f58d3615663f543dd5 |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-04-12T08:33:04Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-8c5f49c05fbb41f58d3615663f543dd52022-12-22T03:40:08ZengElsevierInterdisciplinary Neurosurgery2214-75192020-09-0121100743Ruptured fungal aneurysm of the peripheral middle cerebral artery caused by Lomentospora infection: A case report and literature reviewSho Takata0Akira Tamase1Yasuhiko Hayashi2Kazushi Anzawa3Akihiro Shioya4Yoshitsugu Iinuma5Hideaki Iizuka6Department of Neurosurgery, Kanazawa Medical University, Ishikawa, Japan; Corresponding author at: Department of Neurosurgery, Kanazawa Medical University, 1-1, Daigaku, Uchinada-machi, Kahoku, Ishikawa 920-0293, Japan.Department of Neurosurgery, Kanazawa Medical University, Ishikawa, JapanDepartment of Neurosurgery, Kanazawa Medical University, Ishikawa, JapanDepartment of Dermatology, Kanazawa Medical University, Ishikawa, JapanDepartment of Pathology and Laboratory Medicine, Kanazawa Medical University, Ishikawa, JapanDepartment of Infectious Diseases, Kanazawa Medical University, Ishikawa, JapanDepartment of Neurosurgery, Kanazawa Medical University, Ishikawa, JapanBackground: Infection of Lomentospora (Scedosporium) spp. is very rare but high mortality. Above all, a fungal aneurysm due to Lomentospora spp. is extremely rare. The prognosis of ruptured fungal aneurysm due to Lomentospora spp. is remarkably poor in spite of proper surgical treatment and chemotherapy. Case Description: A 70-year-old female who was having chemotherapy for acute myeloid leukemia suffered from a sudden onset of severe consciousness disturbance. A brain computed tomography (CT) scan revealed large hematoma at the right parietal lobe adjacent to subdural hematoma with a slight subarachnoid hemorrhage. Three dimensional-CT angiography showed an intracranial aneurysm at the right peripheral portion of the middle cerebral artery. Surgical clipping and resection of the aneurysm were successfully performed on the same day. Lomentospora prolificans was identified on the blood culture, and pathological examination of the aneurysmal wall recognized fungus body and hypha. Voriconazole (VRCZ) was administered immediately. However, she died of multiple organ failure 14 days after surgery. Conclusion: In all previously reported cases, fungal aneurysm after a Lomentospora infection led to miserable sequelae even if the aneurysm was properly treated, and VRCZ was administrated. The peripheral portion of the aneurysm due to lomentosporiosis has never been reported. Hematogenous transmission was suggested as a possible developing mechanism.http://www.sciencedirect.com/science/article/pii/S2214751920300414 |
| spellingShingle | Sho Takata Akira Tamase Yasuhiko Hayashi Kazushi Anzawa Akihiro Shioya Yoshitsugu Iinuma Hideaki Iizuka Ruptured fungal aneurysm of the peripheral middle cerebral artery caused by Lomentospora infection: A case report and literature review Interdisciplinary Neurosurgery |
| title | Ruptured fungal aneurysm of the peripheral middle cerebral artery caused by Lomentospora infection: A case report and literature review |
| title_full | Ruptured fungal aneurysm of the peripheral middle cerebral artery caused by Lomentospora infection: A case report and literature review |
| title_fullStr | Ruptured fungal aneurysm of the peripheral middle cerebral artery caused by Lomentospora infection: A case report and literature review |
| title_full_unstemmed | Ruptured fungal aneurysm of the peripheral middle cerebral artery caused by Lomentospora infection: A case report and literature review |
| title_short | Ruptured fungal aneurysm of the peripheral middle cerebral artery caused by Lomentospora infection: A case report and literature review |
| title_sort | ruptured fungal aneurysm of the peripheral middle cerebral artery caused by lomentospora infection a case report and literature review |
| url | http://www.sciencedirect.com/science/article/pii/S2214751920300414 |
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