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J Neurocrit Care 2013;6(2): 111-114.
자기공명영상소견 및 항원검사로 진단한 뇌 아스페르길루스증
김새로미1·강여정1·김태은1·성기범1·이아름2·장기현2·박선아1
순천향대학교 의과대학 부천병원 신경과학교실,1 영상의학교실2
A Case of Cerebral Aspergillosis Diagnosed by Magnetic Resonance Imaging and Antigen Test
Saeromi Kim, MD1, Yeo-Jeong Kang, MD1, Tae-Eun Kim, MD1, Ki-Bum Sung, MD1, A Leum Lee, MD2, Kee-Hyun Chang, MD2, and Sun-Ah Park, MD, PhD1
1Departments of Neurology, 2Radiology, College of Medicine, Soonchunhyang University, Soonchunhynag University Bucheon Hospital, Bucheon, Korea
ABSTRACT
Background: Aspergillosis involving central nervous system (CNS) is very rare. Recently we experienced an old woman with cerebral aspergillosis, in whom characteristic magnetic resonance imaging (MRI) findings and antigen test were helpful in diagnosis.
Case Report: A 87-year-old woman was admitted to the hospital due to diminished cognition and abnormal behavior for two weeks. On brain MRI small multiple conglomerated granulomatous lesions with surrounding extensive vasogenic edema, and multifocal small hemorrhages were observed in right temporal area. Additionally, the titer of Aspergillus antigen test was highly increased. With intravenous antifungal agents the patient’s clinical symptoms were markedly improved.
Conclusions: For CNS aspergillosis the urgent diagnosis followed by appropriate treatment is essential due to its high mortality. The characteristic brain MRI accompanied by high levels of aspergillosis antigen titer could be helpful diagnostic tool of CNS aspergillosis in special situations not being able to obtain pathologic confirmation.
Key Words: CNS infection · Aspergillosis · Voriconazole
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