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Isolated central nervous system mucormycosis
1Department of Medicine, University of Louisville School of Medicine, Ky.
Abstract:
Isolated central nervous system (CNS) mucormycosis is a rare but life-threatening infection. We report a case of bilateral frontal lobe mucormycosis in a previously healthy woman. Intravenous drug use was the most likely route of infection. After treatment with surgical drainage and amphotericin B, she survived but suffered permanent neurologic deficits. We identified 29 previous reports of isolated CNS mucormycosis in the medical literature. Including our case, the patients averaged 32 years of age and most were male. Intravenous drug use appears to be the most important risk factor, present in 20 patients (67%). Treatment with amphotericin B was the only predictor of survival, reducing mortality from 92% to 41%. Isolated CNS mucormycosis should be considered in the differential diagnosis of brain abscesses, especially in intravenous drug users. Prompt initiation of therapy with amphotericin B may be life-saving.
Insights
Central nervous system (CNS) mucormycosis is a rare fungal infection. Intravenous drug use is a key risk factor, and amphotericin B treatment improves survival rates for this dangerous brain infection.
Area of Science:
- Infectious Diseases
- Neurology
- Mycology
Background:
- Isolated central nervous system (CNS) mucormycosis is a rare and frequently fatal infection.
- Prompt diagnosis and treatment are crucial for patient survival.
Observation:
- A case of bilateral frontal lobe mucormycosis in a previously healthy woman is presented.
- Intravenous drug use was identified as the most probable route of infection.
- The patient survived after surgical drainage and amphotericin B treatment but experienced permanent neurological deficits.
Findings:
- A review of 29 previous cases revealed that patients with isolated CNS mucormycosis are typically young males.
- Intravenous drug use is the most significant risk factor, present in 67% of cases.
- Amphotericin B treatment was the sole predictor of survival, decreasing mortality from 92% to 41%.
Implications:
- Isolated CNS mucormycosis should be included in the differential diagnosis for brain abscesses, particularly in intravenous drug users.
- Early administration of amphotericin B is critical and can be life-saving.
- This highlights the importance of considering opportunistic infections in specific patient populations.