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Mycotic aneurysms as lethal complication of brain pseudallescheriasis in a near-drowned child: a CT demonstration

Anna Messori1, Cecilia Lanza, Maurizio De Nicola

  • 1Neuroradiological Clinic, General Hospital Umberto I, Ancona, Italy.

AJNR. American Journal of Neuroradiology
|November 13, 2002
PubMed

Insights

Intracranial true mycotic aneurysms are rare, often fatal fungal infections. A near-drowned child developed fatal Pseudallescheria boydii brain abscesses and aneurysms, highlighting the need for early diagnosis and treatment.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Mycology

Background:

  • Intracranial true mycotic aneurysms (ITMAs) are uncommon and associated with high mortality.
  • Central nervous system (CNS) infections are a recognized complication of near-drowning incidents.
  • Pseudallescheria boydii is a fungus known for its resistance to conventional antifungal therapies.

Observation:

  • A pediatric case of near-drowning presented with multiple brain abscesses.
  • Computed tomography (CT) revealed rapidly developing aneurysms in the basilar and right posterior cerebral arteries.
  • The patient experienced a fatal subarachnoid hemorrhage.

Findings:

  • The brain abscesses and subsequent aneurysms were attributed to Pseudallescheria boydii infection.
  • The fungal pathogen demonstrated resistance to standard antifungal medications.
  • The rapid progression from abscess to aneurysm formation and hemorrhage was noted.

Implications:

  • Early recognition and prompt, targeted antifungal therapy are crucial for patients with CNS infections following near-drowning.
  • The case underscores the aggressive nature of Pseudallescheria boydii in the CNS and the potential for mycotic aneurysm development.
  • This case highlights the importance of considering rare fungal pathogens in near-drowning victims with neurological complications.

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