CT and MRI manifestations of central nervous system infection following allogeneic bone marrow transplantation.
OBJECTIVE
To determine the frequency, microbiological diversity and radiological patterns of central nervous system (CNS) infection following allogeneic bone marrow transplantation (BMT).


METHODS
Two neuroradiologists retrospectively reviewed the computed tomography (CT) and magnetic resonance imaging (MRI) examinations of a large cohort of bone marrow recipients. The radiological findings were correlated with clinical, microbiological and pathological data.


RESULTS
During an 8-year period 406 patients underwent allogeneic BMT; a total of 11 infections of the CNS were diagnosed in nine patients [sino-orbital aspergillosis (3), cerebral aspergillosis (2), pseudomonas (1), listeria (1), human herpes virus-6 (1), herpes zoster (1), toxoplasmosis (1) and progressive multifocal leucoencephalopathy (1)]. The radiological abnormalities could be divided into one or more of the following pathological entities: (i) focal lesions, (ii) invasive sinusitis, (iii) cerebral infarction, (iv) demyelination, (v) encephalitis and (vi) meningitis/hydrocephalus.


CONCLUSIONS
Approximately 2% of bone marrow recipients developed an infection of the CNS. The spectrum of infection changed over time and was related to predictable deficits in host immunity. The radiological appearances were diverse and corresponded to several different pathological processes.
Department of Imaging, Imperial College School of Medicine, Hammersmith Hospital, London, UK.
S C
SC
Coley
H R
HR
Jäger
R M
RM
Szydlo
J M
JM
Goldman
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000276:immunology*; D001927:Brain Diseases / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D016867:Immunocompromised Host; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed