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Cerebral mycetoma with cranial osteomyelitis
Vamseemohan Beeram1, Sundaram Challa, Prasad Vannemreddy
1Department of Neurosurgery, Nizam's Institute of Medical Sciences, Hyderabad, India.
Journal of Neurosurgery. Pediatrics
|June 4, 2008
Summary
This case study details a rare instance of craniocerebral maduromycetoma in a farm laborer. The fungal infection affected the brain, bone, and scalp, presenting unique diagnostic challenges.
Area of Science:
- Mycology
- Neurosurgery
- Radiology
Background:
- Craniocerebral maduromycetoma is an exceptionally rare fungal infection affecting the brain and surrounding tissues.
- This condition typically presents with chronic, non-healing lesions, often in tropical or subtropical regions.
Observation:
- A young male farm laborer presented with a progressively enlarging, discharging sinus on his left parietal scalp.
- Computed tomography (CT) revealed osteomyelitis of the parietal bone with an underlying enhancing intracranial mass.
- Intraoperative findings confirmed a black, friable lesion involving the bone, dura mater, and cerebral cortex, demarcated by a gliotic scar.
Findings:
- The study reports the first instance of cerebral mycetoma with detailed CT findings.
- Gross-total excision of the fungal mass was successfully performed.
- The patient received a 6-week course of itraconazole post-surgery.
Implications:
- This case highlights the importance of considering rare fungal infections in the differential diagnosis of intracranial masses, especially in endemic areas.
- Accurate radiological diagnosis using CT is crucial for identifying craniocerebral mycetoma.
- Successful management involves a combination of surgical resection and appropriate antifungal therapy.
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