A Case of Acute Cerebral Aspergillosis Complicating Influenza A/H1N1pdm 2009
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Invasive aspergillosis is a rare complication in patients with influenza infection. Several cases of invasive pulmonary aspergillosis accompanying influenza infections were reported during the influenza A/H1N1pdm 2009. We encountered a case of acute cerebral aspergillosis in a patient with influenza A/H1N1pdm 2009 infection. A 24-year-old man with uncontrolled diabetes was diagnosed with influenza A/H1N1pdm 2009 infection. Initial evaluation indicated methicillin-sensitive Staphylococcus aureus pneumonia and diabetic ketoacidosis along with influenza. During his hospital course, multiple new rim-enhancing mass lesions not evident in the initial evaluation developed in the fronto-parietal cortical and subcortical white matter and right cerebellum. Pathology and culture results confirmed the presence of Aspergillus fumigatus . Surgical drainage combined with a total of 18 weeks of antifungal therapy resulted in complete resolution of the infection. This case demonstrates that cerebral aspergillosis can present alongside influenza in patients with diabetes or those under intensive care. Clinical suspicion of invasive aspergillosis is required for a definite diagnosis and better prognosis in such cases.
Abstract
Invasive aspergillosis is a rare complication in patients with influenza infection. Several cases of invasive pulmonary aspergillosis accompanying influenza infections were reported during the influenza A/H1N1pdm 2009. We encountered a case of acute cerebral aspergillosis in a patient with influenza A/H1N1pdm 2009 infection. A 24-year-old man with uncontrolled diabetes was diagnosed with influenza A/H1N1pdm 2009 infection. Initial evaluation indicated methicillin-sensitive Staphylococcus aureus pneumonia and diabetic ketoacidosis along with influenza. During his hospital course, multiple new rim-enhancing mass lesions not evident in the initial evaluation developed in the fronto-parietal cortical and subcortical white matter and right cerebellum. Pathology and culture results confirmed the presence of Aspergillus fumigatus . Surgical drainage combined with a total of 18 weeks of antifungal therapy resulted in complete resolution of the infection. This case demonstrates that cerebral aspergillosis can present alongside influenza in patients with diabetes or those under intensive care. Clinical suspicion of invasive aspergillosis is required for a definite diagnosis and better prognosis in such cases.
참고문헌 (21)
- Passouant O, "Pulmonary aspergillosis in non-immunocompromisedpatient with acute respiratory distress syndrome during A(H1N1) infection", Ann Fr Anesth Reanim, 30, pp.e75~e76 (2011)
- Stevens DA, "Aspergillosis in the ‘nonimmunocompromised’host", Immunol Invest, 40, pp.751~766 (2011)
- Garcia-Vidal C, "Invasive aspergillosiscomplicating pandemic influenza A (H1N1) infectionin severely immunocompromised patients", Clin Infect Dis, 53, pp.e16~e19 (2011)
- Carfagna P, "Occurrence of influenza A(H1N1)vinfection and concomitant invasive pulmonary aspergillosisin a patient with chronic obstructive pulmonary disease", Mycoses, 54, pp.549~551 (2011)
- Kousha M, "Pulmonary aspergillosis: aclinical review", Eur Respir Rev, 20, pp.156~174 (2011)
- Dutkiewicz R, "Aspergillus infections in the criticallyill", Proc Am Thorac Soc, 7, pp.204~209 (2010)
- Garnacho-Montero J, "Isolation of Aspergillus spp. from the respiratorytract in critically ill patients: risk factors, clinical presentationand outcome", Crit Care, 9, pp.R191~R199 (2005)
- Meersseman W, "Invasive aspergillosisin critically ill patients without malignancy", Am JRespir Crit Care Med, 170, pp.621~625 (2004)
- Kwoun MO, "Immunologic effects of acute hyperglycemiain nondiabetic rats", JPEN J Parenter Enteral Nutr, 21, pp.91~95 (1997)
- Janes SM, "Invasive pulmonaryaspergillosis in an insulin-dependent diabetic", Respir Med, 92, pp.972~975 (1998)
- Grizzanti JN, "Diabetic ketoacidosis and invasiveaspergillosis", Lung, 159, pp.43~49 (1981)
- Lederer JA, "The effects of injuryon the adaptive immune response", Shock, 11, pp.153~159 (1999)
- Guarner J, "Comparison of the pathologycaused by H1N1, H5N1, and H3N2 influenza viruses", Arch Med Res, 40, pp.655~661 (2009)
- Lewis DE, "Influenza virus infectioninduces functional alterations in peripheral blood lymphocytes", J Immunol, 137, pp.3777~3781 (1986)
- Astry CL, "Influenza virus-induced immune complexessuppress alveolar macrophage phagocytosis", J Virol, 50, pp.287~292 (1984)
- Lee FE, "Fever and progressive respiratory failure in threeelderly family members", Chest, 128, pp.1863~1867 (2005)
- Adalja AA, "Isolation of Aspergillus in three2009 H1N1 influenza patients", Influenza Other Respi Viruses, 5, pp.225~229 (2011)
- Lat A, "Invasive aspergillosis after pandemic (H1N1) 2009", EmergInfect Dis, 16, pp.971~973 (2010)
- Kim SH, "Fatal pandemic influenza A", H1N1infection complicated by probable invasive pulmonaryaspergillosis, 2012, pp.55, 189~192
- Patterson TF, "Invasive aspergillosis. Disease spectrum, treatment practices,and outcomes. I3 Aspergillus Study Group", Medicine(Baltimore), 79, pp.250~260 (2000)
- Britt RH, "Clinical stages of human brain abscesseson serial CT scans after contrast infusion. Computerizedtomographic, neuropathological, and clinicalcorrelations", J Neurosurg, 59, pp.972~989 (1983)