Intracranial Fungal Infections: Overview from Two Large Tertiary Hospital in Upper Egypt and Literature Review

• 作者: Abdin Khair-Allah Kasim Mohamed Khallaf
• 来源期刊: 现代神经外科学进展(英文)
• 学科: 医学
• 关键词: INTRACRANIAL FUNGAL Infection IMMUNOCOMPROMISED Surgery ANTIFUNGAL Outcome
• 年，卷（期）: 2019,（2）
• 页码范围: 184-198
• 页数: 15页
• 分类号: R73

摘要

Purpose: Fungal infections of the central nervous system (CNS) are potentially lethal conditions with high morbidity and mortality. In this review, we summarise the most common clinical manifestations, diagnostic methods, and treatment strategies for intracranial fungal infection at two tertiary care teaching hospitals. Material and methods: Prospective hospital study is carried out at Department of Neurosurgery;Assiut and Suhaj University Hospitals between January2010 to January 2018 (Minimum 12-months follow-up). Radiographs and hospital data of 74 patients with proven intracranial fungal infections were gathered and analyzed. There were no exclusion criteria: age, gender, clinical presentations, immunity status, radiological findings, laboratory, and microbiological data, types of management and outcome. In surgically treated patients, diagnosis was confirmed by pathologic evaluation. Gathered data were coded and entered into a computer and analyzed using SPSS version 22. Results: The greatest number of the patients had 40 to 60 years old (49;66%) and the mean age was 44 years. There was an overwhelming male patient’s ranged preponderance 66%;49 cases. Sixty-three patients (85%) were immunosuppressed;11 cases (15%) were immunocompetent. The most common causes of immunosuppression were diabetes 27 patients;43%, on chemotherapeutic agents 19 patients;31%, on corticosteroid 16 patients;25% and AIDS in one patient;1%. Five different fungal types were identified but Cryptococcus spp. was the most common cause of CNS fungal infection, occurring in 39 patients (53%). This was followed by Candida spp. in 14 patients (19%), Aspergillus in 11 patients (15%), Blastomyces in 7 patients (9%) and Coccidiosis in 3 patients (4%). Headache was the most common presenting symptom, occurring in 33 patients (45%). Other relatively common symptoms were nausea or vomiting 11 patients (15%), fever 10 patients;(13%), seizures 9 patients (12%), acute mental status changes 8 patients;(11%) and stroke like Symptoms 3patients (4%). Diff