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Cerebral mucormycosis in two cases of acquired immunodeficiency syndrome
L M Cuadrado1, A Guerrero, J A Garcia Asenjo
1Department of Internal Medicine, Hospital Clinico de San Carlos, Madrid.
Abstract:
We describe two patients with isolated cerebral mucormycosis and acquired immunodeficiency syndrome (AIDS). Their clinical course was rapid and fatal; early diagnosis and treatment with amphotericin B did not prevent a fatal outcome in both cases. Isolated cerebral mucormycosis has not (to our knowledge) been reported previously in patients with AIDS. Mucormycosis should be included in the differential diagnosis of central nervous system infections in intravenous drug abusers with AIDS. A brain biopsy is needed for the diagnosis of mucormycosis.
Insights
Two patients with AIDS and cerebral mucormycosis experienced a rapid, fatal outcome despite early treatment. This rare fungal infection, mucormycosis, should be considered in AIDS patients with central nervous system infections.
Area of Science:
- Mycology
- Infectious Diseases
- Neurology
Background:
- Acquired immunodeficiency syndrome (AIDS) compromises the immune system, increasing susceptibility to opportunistic infections.
- Mucormycosis is a rare but severe fungal infection, typically affecting immunocompromised individuals.
- Central nervous system (CNS) involvement in mucormycosis is uncommon but carries a high mortality rate.
Observation:
- This report details two cases of isolated cerebral mucormycosis in patients with AIDS.
- Both patients presented with a rapidly progressing and fatal clinical course.
- Despite early diagnosis and treatment with amphotericin B, the outcome was universally fatal.
Findings:
- Isolated cerebral mucormycosis is a previously unreported manifestation in patients with AIDS.
- The aggressive nature of this infection in the described cases highlights its severity.
- Standard treatment protocols may be insufficient to overcome the rapid progression of cerebral mucormycosis in this population.
Implications:
- Mucormycosis must be considered in the differential diagnosis of CNS infections among individuals with AIDS, particularly intravenous drug users.
- Prompt diagnosis, likely requiring brain biopsy, is crucial for identifying this devastating infection.
- Further research is needed to understand the specific pathogenesis and develop effective therapeutic strategies for cerebral mucormycosis in AIDS patients.