Multiple brain abscesses due to Penicillium spp infection.
We present a case of central nervous system (CNS) infection by a member of the Penicillium genera in a HIV-negative man in Brazil. The patient was admitted complaining of loss of visual fields and speech disturbances. CT scan revealed multiple brain abscesses. Stereotactic biopsies revealed fungal infection and amphotericin B treatment begun with initial improvement. The patient died few days later as a consequence of massive gastrointestinal bleeding due to ruptured esophageal varices. The necropsy and final microbiologic analyses disclosed infection by Penicillium sp. There are thousands of fungal species of the Penicillium genera. Systemic penicilliosis is caused by the P. marneffei and was formerly a rare disease, but now is one of the most common opportunistic infection of AIDS patients in Southeast Asia. The clinical presentation usually involves the respiratory system and the skin, besides general symptoms like fever and weight loss. Penicillium spp infection caused by species other than P. marneffei normally cause only superficial or allergic disease but rare cases of invasive disease do occur. We report the fourth case of Penicillium spp CNS infection.
Noritomi
Danilo Teixeira
DT
Gastroenterology Department, Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, SP, Brazil.
Bub
Guilherme Linhares
GL
Beer
Idal
I
da Silva
Aloísio Souza Felipe
AS
de Cleva
Roberto
R
Gama-Rodrigues
Joaquim José
JJ
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D020314:Central Nervous System Fungal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010407:Penicillium / Q000302:isolation & purification*; D014057:Tomography, X-Ray Computed
D000935:Antifungal Agents; D000666:Amphotericin B