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Curvularia brain abscess
Nisha Gadgil1, Michael Kupferman, Sheila Smitherman
1Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
Abstract:
Curvularia is a ubiquitous dematiaceous fungus that is a very rare but often fatal cause of infection in the central nervous system (CNS). In this report, we describe a patient with chronic sinusitis who presented with a Curvularia abscess of the skull base extending into the left frontal lobe. She was successfully treated with aggressive surgical resection and antibiotic therapy. In the published literature, this patient to our knowledge represents the longest period of disease-free follow-up in those afflicted with CNS Curvularia infection, indicating the importance of proper diagnosis and aggressive surgical debridement for a successful outcome.
Insights
Central nervous system (CNS) Curvularia infection is rare and often fatal. This case highlights successful treatment of a skull base abscess with surgery and antibiotics, achieving the longest disease-free follow-up reported.
Area of Science:
- Mycology
- Infectious Diseases
- Neurology
Background:
- Curvularia species are common fungi, but rarely cause central nervous system (CNS) infections.
- CNS infections by Curvularia are associated with high mortality rates.
Observation:
- A patient with chronic sinusitis developed a Curvularia abscess at the skull base with extension into the left frontal lobe.
- The patient presented with neurological symptoms secondary to the abscess.
Findings:
- Successful treatment was achieved through aggressive surgical resection of the abscess and a course of antibiotic therapy.
- This case reports the longest disease-free follow-up period for a patient with CNS Curvularia infection in the published literature.
Implications:
- Early and accurate diagnosis of CNS Curvularia infections is critical for patient outcomes.
- Aggressive surgical debridement, in conjunction with appropriate antibiotic treatment, is essential for successful management and long-term recovery.
- This case underscores the importance of considering rare fungal pathogens in the differential diagnosis of CNS infections, particularly in immunocompromised or chronically ill patients.
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