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Scedosporium apiospermum as a rare cause of central skull base osteomyelitis.

Jalava-Karvinen P, Nyman M, Gardberg M, Harju I, Hohenthal U, Oksi J - Med Mycol Case Rep (2016)

Bottom Line: We report a case of Scedosporium apiospermum mold causing ear infection, central skull base osteomyelitis and finally, occlusion of carotid artery in a 48-year-old diabetic man.The exact diagnosis was established and the severity of the disease understood several months after the onset of symptoms.Despite of appropriate antifungal therapy, and repeated surgical and otological procedures, the infection progressed to fatal cerebral infarction.

View Article: PubMed Central - PubMed

Affiliation: Department of Infectious Diseases, Division of Medicine, Turku University Hospital, Turku, Finland; Faculty of Medicine, Turku University, Turku, Finland.

ABSTRACT
We report a case of Scedosporium apiospermum mold causing ear infection, central skull base osteomyelitis and finally, occlusion of carotid artery in a 48-year-old diabetic man. The exact diagnosis was established and the severity of the disease understood several months after the onset of symptoms. Despite of appropriate antifungal therapy, and repeated surgical and otological procedures, the infection progressed to fatal cerebral infarction.

No MeSH data available.


Related in: MedlinePlus

MRI showing the evolution of the right ICA (arrow) infiltration at the level of cavernous sinus. On day 80 there is no visible infiltration and vessel walls are normal. On day 97, vessel walls are thick and the flow in the ICA seems to be slower. On day 135, the whole right ICA is occluded by non-enhancing material which was later proven to be of fungal origin.
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f0005: MRI showing the evolution of the right ICA (arrow) infiltration at the level of cavernous sinus. On day 80 there is no visible infiltration and vessel walls are normal. On day 97, vessel walls are thick and the flow in the ICA seems to be slower. On day 135, the whole right ICA is occluded by non-enhancing material which was later proven to be of fungal origin.

Mentions: He had no signs of an acute infection, but complained of double images. Right-sided abducens nerve paresis was observed. C-reactive protein was 33 mg/l (normal<10 mg/l), and white blood cell count 8.0×109/l (normal 3.4–8.2×109/l). MRI showed a cerebral lesion that was interpreted as ischemic or infective. There was a suspicion of vessel wall inflammation in the right ICA at the level of skull base (Fig. 1). The cerebrospinal fluid (CSF) contained no leukocytes but protein was elevated at 800 mg/l (normal 150–450 mg/l). Fungal polymerase chain reaction (PCR) showed weak positivity for Aspergillus nidulans considered as a contamination by the laboratory. Fungal and bacterial cultures remained negative.


Scedosporium apiospermum as a rare cause of central skull base osteomyelitis.

Jalava-Karvinen P, Nyman M, Gardberg M, Harju I, Hohenthal U, Oksi J - Med Mycol Case Rep (2016)

MRI showing the evolution of the right ICA (arrow) infiltration at the level of cavernous sinus. On day 80 there is no visible infiltration and vessel walls are normal. On day 97, vessel walls are thick and the flow in the ICA seems to be slower. On day 135, the whole right ICA is occluded by non-enhancing material which was later proven to be of fungal origin.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834721&req=5

f0005: MRI showing the evolution of the right ICA (arrow) infiltration at the level of cavernous sinus. On day 80 there is no visible infiltration and vessel walls are normal. On day 97, vessel walls are thick and the flow in the ICA seems to be slower. On day 135, the whole right ICA is occluded by non-enhancing material which was later proven to be of fungal origin.
Mentions: He had no signs of an acute infection, but complained of double images. Right-sided abducens nerve paresis was observed. C-reactive protein was 33 mg/l (normal<10 mg/l), and white blood cell count 8.0×109/l (normal 3.4–8.2×109/l). MRI showed a cerebral lesion that was interpreted as ischemic or infective. There was a suspicion of vessel wall inflammation in the right ICA at the level of skull base (Fig. 1). The cerebrospinal fluid (CSF) contained no leukocytes but protein was elevated at 800 mg/l (normal 150–450 mg/l). Fungal polymerase chain reaction (PCR) showed weak positivity for Aspergillus nidulans considered as a contamination by the laboratory. Fungal and bacterial cultures remained negative.

Bottom Line: We report a case of Scedosporium apiospermum mold causing ear infection, central skull base osteomyelitis and finally, occlusion of carotid artery in a 48-year-old diabetic man.The exact diagnosis was established and the severity of the disease understood several months after the onset of symptoms.Despite of appropriate antifungal therapy, and repeated surgical and otological procedures, the infection progressed to fatal cerebral infarction.

View Article: PubMed Central - PubMed

Affiliation: Department of Infectious Diseases, Division of Medicine, Turku University Hospital, Turku, Finland; Faculty of Medicine, Turku University, Turku, Finland.

ABSTRACT
We report a case of Scedosporium apiospermum mold causing ear infection, central skull base osteomyelitis and finally, occlusion of carotid artery in a 48-year-old diabetic man. The exact diagnosis was established and the severity of the disease understood several months after the onset of symptoms. Despite of appropriate antifungal therapy, and repeated surgical and otological procedures, the infection progressed to fatal cerebral infarction.

No MeSH data available.


Related in: MedlinePlus