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Granulomatous encephalitis caused by Bipolaris hawaiiensis
Archives of Pathology & Laboratory Medicine
|December 1, 1986
Summary
This study details a rare granulomatous encephalitis case in an immunocompetent patient caused by Bipolaris hawaiiensis. Successful treatment involved surgery and amphotericin B therapy.
Area of Science:
- Neurology
- Mycology
- Infectious Diseases
Background:
- Granulomatous encephalitis is a rare inflammatory brain condition.
- Fungal infections of the central nervous system are uncommon, particularly in immunocompetent individuals.
Observation:
- An 18-year-old male presented with seizures and leg weakness.
- Imaging revealed a left frontoparietal enhancing lesion.
- Biopsy showed granulomatous inflammation and fungal hyphae.
Findings:
- Bipolaris hawaiiensis was identified as the causative agent.
- Antifungal susceptibility testing indicated sensitivity to amphotericin B and miconazole, but resistance to flucytosine.
- No in vitro synergy was observed between amphotericin B and flucytosine.
Implications:
- This case highlights Bipolaris hawaiiensis as a potential cause of encephalitis in immunocompetent hosts.
- Successful treatment involved a combination of surgical resection and systemic/intrathecal amphotericin B.
- Early diagnosis and targeted antifungal therapy are crucial for managing such rare fungal brain infections.