title: Disseminated zygomycosis with involvement of the central nervous system.
abstract: Zygomycosis of the central nervous system (CNS) can manifest in three distinct clinical forms, as rhinocerebral zygomycosis, as disseminated zygomycosis with CNS involvement, and as isolated cerebral zygomycosis. We present a case of a 2-year-old boy with leukaemia and disseminated zygomycosis, caused by Absidia corymbifera, involving the brain, spinal cord, lung and liver. The child received treatment with liposomal amphotericin B and posaconazole for 6 months. Although the lesions of the lungs and liver resolved, those of the CNS persisted and the child is in a vegetative state. A review of the literature after 2004 identified ten additional cases of disseminated zygomycosis with cerebral involvement, all but one of which had concurrent lung infection. The most common underlying disease in these cases was haematological malignancy and the mortality rate was 70%. Disseminated zygomycosis with cerebral involvement is a fatal disease. Early recognition and prompt intervention with combined medical and surgical treatment may improve the outcome.
authors.affiliation: 1st Department of Propedeutic Medicine, Athens University, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Skiada
authors.forename: L
authors.initials: L
authors.lastname: Vrana
authors.forename: H
authors.initials: H
authors.lastname: Polychronopoulou
authors.forename: P
authors.initials: P
authors.lastname: Prodromou
authors.forename: A
authors.initials: A
authors.lastname: Chantzis
authors.forename: P
authors.initials: P
authors.lastname: Tofas
authors.forename: G L
authors.initials: GL
authors.lastname: Daikos
mesh_terms: D020095:Absidia / Q000302:isolation & purification*; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001921:Brain / Q000382:microbiology / Q000473:pathology; D020314:Central Nervous System Fungal Infections / Q000175:diagnosis* / Q000382:microbiology; D002675:Child, Preschool; D006801:Humans; D008099:Liver / Q000382:microbiology / Q000473:pathology; D008168:Lung / Q000382:microbiology / Q000473:pathology; D008297:Male; D009091:Mucormycosis / Q000150:complications* / Q000175:diagnosis*; D013116:Spinal Cord / Q000382:microbiology / Q000473:pathology; D014230:Triazoles / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D014230:Triazoles; C068538:liposomal amphotericin B; C101425:posaconazole; D000666:Amphotericin B