[Case of basilar artery occlusion caused by mucormycotic embolism in the course of myelodysplastic syndrome].
We report the case of a man in his sixties with mucormycosis in whom initial cerebellar infarction progressed into pontine infarction due to basilar artery occlusion. He had received blood transfusions for myelodysplastic syndrome for 1 year and suddenly developed ataxic speech and gait disturbances. On the basis of the diagnosis of cerebellar infarction and pneumonia, he was administered antifungal medications (micafungin sodium, fosfluconazole, and amphotericin B) in addition to glycerin, after which the patient suffered from high fever associated with meningeal irritation and consciousness disturbance. Diffusion-weighted images derived from brain magnetic resonance imaging (MRI) revealed the presence of high-signal intensity lesions extending to the bilateral pons. He died of tonsillar herniation associated with brainstem edema. Autopsy revealed mucormycosis occluding and invading the basilar artery, which caused fatal brainstem infarction. This case highlights the importance of the opportunistic infection, namely, mucormycosis, which is caused by Mucor.
Department of Neurology, Dokkyo Medical University, Kitakobayashi 880, Mibu-machi, Shimotsuga-gun, Tochigi 321-0293, Japan.
Ryotaro
R
Takashima
Masaaki
M
Odaka
Yuka
Y
Watanabe
Koichi
K
Hirat
Atsushi
A
Yoshida
D001157:Arterial Occlusive Diseases / Q000209:etiology*; D001488:Basilar Artery; D020526:Brain Stem Infarctions / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000150:complications*; D009190:Myelodysplastic Syndromes / Q000150:complications*; D009894:Opportunistic Infections / Q000150:complications*