title: Fungal meningoencephalitis caused by Alternaria: a clinical case.
abstract: Cerebral phaeohyphomycosis is an infrequent infectious condition associated with a high mortality rate. The authors describe a very rare case that occurred in an immunocompetent 18-year-old man who developed severe meningoencephalitis and arachnoiditis caused by Alternaria alternata, which were diagnosed in the context of difficult-to-treat hydrocephalus. Etiological diagnosis was made based on fungal culture and histopathologic examination. Empirical treatment consisted of an early aggressive antifungal combination therapy consisting of intravenous liposomal amphotericin B (5 mg/kg per day) and voriconazole (4 mg/kg every 12 h), which initially induced a favorable response. Following the fungus identification, the choice for the combination of posaconazole (400 mg every 12 h) plus flucytosine (4000 mg/day) proved to be effective in the suppression of the signs and symptoms of this uncommon cerebral mycosis. At a 12-month follow-up visit no recurrence had occurred and posaconazole was then stopped.
authors: Neurosurgery Service, Hospital Egas Moniz - Centro Hospitalar de Lisboa Ocidental, EPE, Lisbon, Portugal. cjeancs@yahoo.com.br
authors: Cícero J C
authors: CJ
authors: Silveira
authors: Joana
authors: J
authors: Amaral
authors: Rodrigo P
authors: RP
authors: Gorayeb
authors: José
authors: J
authors: Cabral
authors: Teresa
authors: T
authors: Pacheco
mesh_terms: D000293:Adolescent; D000528:Alternaria / Q000302:isolation & purification / Q000472:pathogenicity*; D060487:Alternariosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D000935:Antifungal Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008590:Meningoencephalitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000935:Antifungal Agents
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