Isolated Invasive Cerebral Mucormycosis in a Diabetc Female Patent: A Case Report With Rising Concerns
,
Abstract
Isolated cerebral mucormycosis can be life-threatening in immunocompromised patients. Sinus and lung were the most involved organs, while cerebral infection by mucormycosis is more fetal. This infection needs proper debridement and antifungal therapy. We report a 12-year-old diabetic girl with manifestations of fever, headache, and weakness in the right upper and lower extremities without any involvement of sinuses and lung. The patient had approximately normal routine laboratory data, and its CSF was not diagnostic. Because of its features in brain CT and MRI that suggested a necrotic lesion in the left parietal lobe, she was undergone craniotomy and received broad-spectrum antibiotics along with anti-fungal and anti-tuberculosis drugs. Histopathological findings of the mass, which was excised in craniotomy, confirmed the diagnosis of mucormycosis. Unfortunately, the patient died because of this invasive infection. The fatality of fungal infections, especially cerebral types, warn us to be aware of them in immunocompromised patients and perform the proper treatment to reduce its mortality.
[2] Panackal AA, Williamson PR. Fungal infectons of the central nervous system. Contnuum Lifelong Learning in Neurology. 2015; 21(6):1662-78. [DOI:10.1212/CON.0000000000000241] [PMID]
[3] Roden MM, Zaouts TE, Buchanan WL, Knudsen TA, Sarkisova TA, Schaufele RL, et al. Epidemiology and outcome of zygomycosis: A review of 929 reported cases. Clinical Infectous Diseases. 2005; 41(5):634-53. [DOI:10.1086/432579] [PMID]
[4] Verma A, Brozman B, Petto CK. Isolated cerebral mucormycosis: Report of a case and review of the literature. Journal of Neurology Sciences. 2006; 240(1-2):65-9. [DOI:10.1016/j.jns.2005.09.010] [PMID]
[5] Góralska K, Blaszkowska J, Dzikowiec M. Neuroinfectons caused by fungi. Infecton. 2018; 46(Suppl):1-17. [DOI:10.1007/s15010-018- 1152-2] [PMID] [PMCID]
[6] Balaguer Rosello A, Bataller L, Lorenzo I, Jarque I, Salavert M, González E, et al. Infectons of the central nervous system afer unrelated donor umbilical cord blood transplantaton or human leukocyte antgen-matched sibling transplantaton. Biology of Blood and Marrow Transplantaton. 2017; 23(1):134-9. [DOI:10.1016/j. bbmt.2016.10.005] [PMID]
[7] Man A, Mare A, Toma F, Curtcăpean A, Santacroce L. Health threats from contaminaton of spices commercialized in romania: Risks of fungal and bacterial infectons. Endocrine Metabolic & Immune Disorders-Drug Targets. 2016; 16(3):197-204. [DOI:10.2174/ 1871530316666160823145817] [PMID]
[8] Green KK, Barham HP, Allen GC, Chan KH. Prognostc factors in the outcome of invasive fungal sinusits in a pediatric populaton. Pediatric Infectous Disease Journal. 2016; 35(4):384-6. [DOI:10.1097/ INF.0000000000001015] [PMID]
[9] Ba PF, Shi LG, Li SC, Yin ZH, Wang GK. [Endoscopic sinus surgery for the treatment of invasive fungal sinusits (Chinese)]. Journal of Clinical Otorhinolaryngology. 2017; 31(15):1195-8. [DOI:10.13201/j. issn.1001-1781.2017.15.013] [PMID]
[10] Irikuchi J, Imai T, Tanaka M, Tanuma M, Orii T, Kato T. Meta-analysis on the influence of antfungal spectrum on effectveness of empirical antfungal therapy for febrile neutropenia. Yakugaku Zasshi. 2017; 137(9):1117-27. DOI:10.1248/yakushi.16-00216] [PMID]
| Files | ||
| Issue | Vol 4 No 2 (2019): Spring | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v4i2.1703 | |
| Keywords | ||
| Cerebral mucormycosis Major thalassemia Diabetes mellitus | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
