CNS aspergillosis in organ transplantation: a clinicopathological study.
Identifieur interne : 000396 ( Istex/Corpus ); précédent : 000395; suivant : 000397CNS aspergillosis in organ transplantation: a clinicopathological study.
Auteurs : J. Torre-Cisneros ; O L Lopez ; S. Kusne ; A J Martinez ; T E Starzl ; R L Simmons ; M. MartinSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 1993-02.
English descriptors
- KwdEn :
- Abscess, Antilymphocyte globulin, Aspergillosis, Aspergillus, Aspergillus infection, Blood vessel walls, Blood vessels, Brain biopsy, Cardiac transplant recipients, Cardiac transplantation, Cerebellar, Cerebellar abscesses, Cerebral hemispheres, Clinical suspicion, Clinicopathological, Clinicopathological study, Cluster transplants, Critical period, Cyclosporin, Different types, First year, Focal motor deficits, Fungal invasion, Haemorrhage, Haemorrhagic, Haemorrhagic infarct, Haemorrhagic infarcts, Infarct, Infection, Intense immunosuppression, Invasive aspergillosis, Ischaemic, Ischaemic infarcts, Kidney transplant, Kidney transplant patients, Kusne, Lesion, Liver transplant, Liver transplant patients, Liver transplantation, Meningeal signs, Mental status, Midbrain, Midbrain ischaemic infarcts, Monoclonal globulin, Motor deficits, Multiple abscesses, Mycotic aneurysm, Necropsy, Neurol, Neurological complications, Neurology, Neuropathological, Neuropathological findings, Organ rejection, Organ transplant recipients, Organ transplantation, Orthotopic liver transplantation, Previous reports, Rabbit globulin, Rejection episodes, Renal transplant recipients, Starzl, Structural lesions, Subarachnoid, Subarachnoid haemorrhage, Subsequent ischaemic, Transplant, Transplant patients, Transplant proc, Transplant recipients, Transplantation, Unknown aetiology.
- Teeft :
- Abscess, Antilymphocyte globulin, Aspergillosis, Aspergillus, Aspergillus infection, Blood vessel walls, Blood vessels, Brain biopsy, Cardiac transplant recipients, Cardiac transplantation, Cerebellar, Cerebellar abscesses, Cerebral hemispheres, Clinical suspicion, Clinicopathological, Clinicopathological study, Cluster transplants, Critical period, Cyclosporin, Different types, First year, Focal motor deficits, Fungal invasion, Haemorrhage, Haemorrhagic, Haemorrhagic infarct, Haemorrhagic infarcts, Infarct, Infection, Intense immunosuppression, Invasive aspergillosis, Ischaemic, Ischaemic infarcts, Kidney transplant, Kidney transplant patients, Kusne, Lesion, Liver transplant, Liver transplant patients, Liver transplantation, Meningeal signs, Mental status, Midbrain, Midbrain ischaemic infarcts, Monoclonal globulin, Motor deficits, Multiple abscesses, Mycotic aneurysm, Necropsy, Neurol, Neurological complications, Neurology, Neuropathological, Neuropathological findings, Organ rejection, Organ transplant recipients, Organ transplantation, Orthotopic liver transplantation, Previous reports, Rabbit globulin, Rejection episodes, Renal transplant recipients, Starzl, Structural lesions, Subarachnoid, Subarachnoid haemorrhage, Subsequent ischaemic, Transplant, Transplant patients, Transplant proc, Transplant recipients, Transplantation, Unknown aetiology.
Abstract
The clinical characteristics and neuropathological findings of 22 organ transplant recipients with CNS aspergillosis were reviewed. Thirteen patients had liver, six kidney, two heart and one had cluster transplants. The most frequent neurological symptoms were alteration of mental status (86%), seizures (41%) and focal neurological deficits (32%). Meningeal signs were less common (19%). Aspergillus spp invasion of the blood vessels with subsequent ischaemic or haemorrhagic infarcts, and solitary or multiple abscesses were the predominant neuropathological findings. The lungs were the probable portal of entry; however, isolated CNS aspergillosis was seen in two patients. Antemortem diagnosis of the infection was made in half of the patients. Concomitant diabetes mellitus was noted in 59% of the patients and bacterial or other severe infections in 86%. No specific clinical or pathological pattern could be identified among patients with different types of organ transplants. In addition CNS aspergillosis was preceded by organ rejection and the need for intense immunosuppression and retransplantation in the majority of the patients.
Url:
DOI: 10.1136/jnnp.56.2.188
Links to Exploration step
ISTEX:1146B1CB51D6F0DFCE9B7736F8DC5DDA73BEA65ELe document en format XML
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Torre-Cisneros</name><affiliation><mods:affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</mods:affiliation></affiliation></author><author><name sortKey="Lopez, O L" sort="Lopez, O L" uniqKey="Lopez O" first="O L" last="Lopez">O L Lopez</name><affiliation><mods:affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</mods:affiliation></affiliation></author><author><name sortKey="Kusne, S" sort="Kusne, S" uniqKey="Kusne S" first="S" last="Kusne">S. 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Martin</name><affiliation><mods:affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="1993-02">1993-02</date><biblScope unit="volume">56</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="188">188</biblScope></imprint><idno type="ISSN">0022-3050</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Abscess</term><term>Antilymphocyte globulin</term><term>Aspergillosis</term><term>Aspergillus</term><term>Aspergillus infection</term><term>Blood vessel walls</term><term>Blood vessels</term><term>Brain biopsy</term><term>Cardiac transplant recipients</term><term>Cardiac transplantation</term><term>Cerebellar</term><term>Cerebellar abscesses</term><term>Cerebral hemispheres</term><term>Clinical suspicion</term><term>Clinicopathological</term><term>Clinicopathological study</term><term>Cluster transplants</term><term>Critical period</term><term>Cyclosporin</term><term>Different types</term><term>First year</term><term>Focal motor deficits</term><term>Fungal invasion</term><term>Haemorrhage</term><term>Haemorrhagic</term><term>Haemorrhagic infarct</term><term>Haemorrhagic infarcts</term><term>Infarct</term><term>Infection</term><term>Intense immunosuppression</term><term>Invasive aspergillosis</term><term>Ischaemic</term><term>Ischaemic infarcts</term><term>Kidney transplant</term><term>Kidney transplant patients</term><term>Kusne</term><term>Lesion</term><term>Liver transplant</term><term>Liver transplant patients</term><term>Liver transplantation</term><term>Meningeal signs</term><term>Mental status</term><term>Midbrain</term><term>Midbrain ischaemic infarcts</term><term>Monoclonal globulin</term><term>Motor deficits</term><term>Multiple abscesses</term><term>Mycotic aneurysm</term><term>Necropsy</term><term>Neurol</term><term>Neurological complications</term><term>Neurology</term><term>Neuropathological</term><term>Neuropathological findings</term><term>Organ rejection</term><term>Organ transplant recipients</term><term>Organ transplantation</term><term>Orthotopic liver transplantation</term><term>Previous reports</term><term>Rabbit globulin</term><term>Rejection episodes</term><term>Renal transplant recipients</term><term>Starzl</term><term>Structural lesions</term><term>Subarachnoid</term><term>Subarachnoid haemorrhage</term><term>Subsequent ischaemic</term><term>Transplant</term><term>Transplant patients</term><term>Transplant proc</term><term>Transplant recipients</term><term>Transplantation</term><term>Unknown aetiology</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Abscess</term><term>Antilymphocyte globulin</term><term>Aspergillosis</term><term>Aspergillus</term><term>Aspergillus infection</term><term>Blood vessel walls</term><term>Blood vessels</term><term>Brain biopsy</term><term>Cardiac transplant recipients</term><term>Cardiac transplantation</term><term>Cerebellar</term><term>Cerebellar abscesses</term><term>Cerebral hemispheres</term><term>Clinical suspicion</term><term>Clinicopathological</term><term>Clinicopathological study</term><term>Cluster transplants</term><term>Critical period</term><term>Cyclosporin</term><term>Different types</term><term>First year</term><term>Focal motor deficits</term><term>Fungal invasion</term><term>Haemorrhage</term><term>Haemorrhagic</term><term>Haemorrhagic infarct</term><term>Haemorrhagic infarcts</term><term>Infarct</term><term>Infection</term><term>Intense immunosuppression</term><term>Invasive aspergillosis</term><term>Ischaemic</term><term>Ischaemic infarcts</term><term>Kidney transplant</term><term>Kidney transplant patients</term><term>Kusne</term><term>Lesion</term><term>Liver transplant</term><term>Liver transplant patients</term><term>Liver transplantation</term><term>Meningeal signs</term><term>Mental status</term><term>Midbrain</term><term>Midbrain ischaemic infarcts</term><term>Monoclonal globulin</term><term>Motor deficits</term><term>Multiple abscesses</term><term>Mycotic aneurysm</term><term>Necropsy</term><term>Neurol</term><term>Neurological complications</term><term>Neurology</term><term>Neuropathological</term><term>Neuropathological findings</term><term>Organ rejection</term><term>Organ transplant recipients</term><term>Organ transplantation</term><term>Orthotopic liver transplantation</term><term>Previous reports</term><term>Rabbit globulin</term><term>Rejection episodes</term><term>Renal transplant recipients</term><term>Starzl</term><term>Structural lesions</term><term>Subarachnoid</term><term>Subarachnoid haemorrhage</term><term>Subsequent ischaemic</term><term>Transplant</term><term>Transplant patients</term><term>Transplant proc</term><term>Transplant recipients</term><term>Transplantation</term><term>Unknown aetiology</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The clinical characteristics and neuropathological findings of 22 organ transplant recipients with CNS aspergillosis were reviewed. Thirteen patients had liver, six kidney, two heart and one had cluster transplants. The most frequent neurological symptoms were alteration of mental status (86%), seizures (41%) and focal neurological deficits (32%). Meningeal signs were less common (19%). Aspergillus spp invasion of the blood vessels with subsequent ischaemic or haemorrhagic infarcts, and solitary or multiple abscesses were the predominant neuropathological findings. The lungs were the probable portal of entry; however, isolated CNS aspergillosis was seen in two patients. Antemortem diagnosis of the infection was made in half of the patients. Concomitant diabetes mellitus was noted in 59% of the patients and bacterial or other severe infections in 86%. No specific clinical or pathological pattern could be identified among patients with different types of organ transplants. In addition CNS aspergillosis was preceded by organ rejection and the need for intense immunosuppression and retransplantation in the majority of the patients.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>aspergillosis</json:string><json:string>transplantation</json:string><json:string>haemorrhagic</json:string><json:string>abscess</json:string><json:string>aspergillus</json:string><json:string>ischaemic</json:string><json:string>cerebellar</json:string><json:string>transplant</json:string><json:string>infarct</json:string><json:string>haemorrhage</json:string><json:string>subarachnoid</json:string><json:string>organ transplantation</json:string><json:string>starzl</json:string><json:string>kusne</json:string><json:string>neurol</json:string><json:string>mental 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Pittsburgh, School of Medicine, Pennsylvania.</json:string></affiliations></json:item><json:item><name>S Kusne</name><affiliations><json:string>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</json:string></affiliations></json:item><json:item><name>A J Martinez</name><affiliations><json:string>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</json:string></affiliations></json:item><json:item><name>T E Starzl</name><affiliations><json:string>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</json:string></affiliations></json:item><json:item><name>R L Simmons</name><affiliations><json:string>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</json:string></affiliations></json:item><json:item><name>M Martin</name><affiliations><json:string>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</json:string></affiliations></json:item></author><arkIstex>ark:/67375/NVC-9H5B1DTS-L</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>The clinical characteristics and neuropathological findings of 22 organ transplant recipients with CNS aspergillosis were reviewed. Thirteen patients had liver, six kidney, two heart and one had cluster transplants. The most frequent neurological symptoms were alteration of mental status (86%), seizures (41%) and focal neurological deficits (32%). Meningeal signs were less common (19%). Aspergillus spp invasion of the blood vessels with subsequent ischaemic or haemorrhagic infarcts, and solitary or multiple abscesses were the predominant neuropathological findings. The lungs were the probable portal of entry; however, isolated CNS aspergillosis was seen in two patients. Antemortem diagnosis of the infection was made in half of the patients. Concomitant diabetes mellitus was noted in 59% of the patients and bacterial or other severe infections in 86%. No specific clinical or pathological pattern could be identified among patients with different types of organ transplants. In addition CNS aspergillosis was preceded by organ rejection and the need for intense immunosuppression and retransplantation in the majority of the patients.</abstract><qualityIndicators><score>7.662</score><pdfWordCount>3706</pdfWordCount><pdfCharCount>26274</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>6</pdfPageCount><pdfPageSize>595.27 x 841.89 pts (A4)</pdfPageSize><refBibsNative>false</refBibsNative><abstractWordCount>163</abstractWordCount><abstractCharCount>1145</abstractCharCount><keywordCount>0</keywordCount></qualityIndicators><title>CNS aspergillosis in organ transplantation: a clinicopathological study.</title><pmid><json:string>8437008</json:string></pmid><genre><json:string>research-article</json:string></genre><host><title>Journal of Neurology, Neurosurgery & Psychiatry</title><language><json:string>unknown</json:string></language><issn><json:string>0022-3050</json:string></issn><eissn><json:string>1468-330X</json:string></eissn><volume>56</volume><issue>2</issue><pages><first>188</first></pages><genre><json:string>journal</json:string></genre></host><namedEntities><unitex><date><json:string>2121</json:string><json:string>2180</json:string><json:string>from January 1981 to December 1990</json:string><json:string>1988</json:string><json:string>1993-02-01</json:string></date><geogName></geogName><orgName><json:string>University of Minnesota Hospital</json:string><json:string>Reina Sofia Hospital, University of Cordoba School of Medicine</json:string><json:string>University of Pittsburgh</json:string><json:string>Lopez Department of Medicine S Kusne Department of Pathology</json:string><json:string>UPMC</json:string><json:string>Martin Department of Neurology</json:string><json:string>University of Pittsburgh Medical Center</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Ann Surg</json:string><json:string>Ann Neurol</json:string><json:string>Mechanisms</json:string><json:string>Lopez</json:string><json:string>Martinez Correspondence</json:string><json:string>Visiting Fellow</json:string><json:string>Torre-Cisneros</json:string><json:string>S. Aspergillosis</json:string><json:string>Deborah Pulkowski</json:string><json:string>Ann Intern</json:string><json:string>Thor Card</json:string><json:string>Julio Martinez</json:string><json:string>Martin Abstract</json:string><json:string>Shimon Kusne</json:string><json:string>Richard L Simmons</json:string><json:string>Oscar L Lopez</json:string></persName><placeName><json:string>Amsterdam</json:string><json:string>Chicago</json:string><json:string>Spain</json:string><json:string>PA</json:string></placeName><ref_url></ref_url><ref_bibl><json:string>Torres-Cisneros et al</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/NVC-9H5B1DTS-L</json:string></ark><categories><wos><json:string>1 - social science</json:string><json:string>2 - psychiatry</json:string><json:string>1 - science</json:string><json:string>2 - surgery</json:string><json:string>2 - clinical neurology</json:string></wos><scienceMetrix><json:string>1 - health 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GROBID</resp><name resp="ISTEX-API">ISTEX-API (INIST-CNRS)</name></respStmt></titleStmt><publicationStmt><authority>ISTEX</authority><publisher scheme="https://publisher-list.data.istex.fr">BMJ Publishing Group Ltd</publisher><availability><licence><p>© British Medical Journal Publishing Group</p></licence><p scheme="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</p></availability><date>1993-02-01</date></publicationStmt><notesStmt><note type="research-article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">CNS aspergillosis in organ transplantation: a clinicopathological study.</title><author xml:id="author-0000"><persName><forename type="first">J</forename><surname>Torre-Cisneros</surname></persName><affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</affiliation></author><author xml:id="author-0001"><persName><forename type="first">O L</forename><surname>Lopez</surname></persName><affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</affiliation></author><author xml:id="author-0002"><persName><forename type="first">S</forename><surname>Kusne</surname></persName><affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</affiliation></author><author xml:id="author-0003"><persName><forename type="first">A J</forename><surname>Martinez</surname></persName><affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</affiliation></author><author xml:id="author-0004"><persName><forename type="first">T E</forename><surname>Starzl</surname></persName><affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</affiliation></author><author xml:id="author-0005"><persName><forename type="first">R L</forename><surname>Simmons</surname></persName><affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</affiliation></author><author xml:id="author-0006"><persName><forename type="first">M</forename><surname>Martin</surname></persName><affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</affiliation></author><idno type="istex">1146B1CB51D6F0DFCE9B7736F8DC5DDA73BEA65E</idno><idno type="ark">ark:/67375/NVC-9H5B1DTS-L</idno><idno type="DOI">10.1136/jnnp.56.2.188</idno><idno type="href">jnnp-56-188.pdf</idno><idno type="PMID">8437008</idno><idno type="local">jnnp;56/2/188</idno></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><idno type="PublisherID-hwp">jnnp</idno><idno type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="1993-02"></date><biblScope unit="volume">56</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="188">188</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1993-02-01</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>The clinical characteristics and neuropathological findings of 22 organ transplant recipients with CNS aspergillosis were reviewed. Thirteen patients had liver, six kidney, two heart and one had cluster transplants. The most frequent neurological symptoms were alteration of mental status (86%), seizures (41%) and focal neurological deficits (32%). Meningeal signs were less common (19%). Aspergillus spp invasion of the blood vessels with subsequent ischaemic or haemorrhagic infarcts, and solitary or multiple abscesses were the predominant neuropathological findings. The lungs were the probable portal of entry; however, isolated CNS aspergillosis was seen in two patients. Antemortem diagnosis of the infection was made in half of the patients. Concomitant diabetes mellitus was noted in 59% of the patients and bacterial or other severe infections in 86%. No specific clinical or pathological pattern could be identified among patients with different types of organ transplants. In addition CNS aspergillosis was preceded by organ rejection and the need for intense immunosuppression and retransplantation in the majority of the patients.</p></abstract></profileDesc><revisionDesc><change when="1993-02-01">Created</change><change when="1993-02">Published</change><change xml:id="refBibs-istex" who="#ISTEX-API" when="2017-10-17">References added</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/1146B1CB51D6F0DFCE9B7736F8DC5DDA73BEA65E/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">jnnp</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-title>Journal of Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">8437008</article-id><article-id pub-id-type="other">jnnp;56/2/188</article-id><article-id pub-id-type="doi">10.1136/jnnp.56.2.188</article-id><article-id pub-id-type="other">188</article-id><article-id pub-id-type="other">jnnp.56.2.188</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>CNS aspergillosis in organ transplantation: a clinicopathological study.</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Torre-Cisneros</surname><given-names>J</given-names></name></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Lopez</surname><given-names>O L</given-names></name></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Kusne</surname><given-names>S</given-names></name></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Martinez</surname><given-names>A J</given-names></name></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Starzl</surname><given-names>T E</given-names></name></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Simmons</surname><given-names>R L</given-names></name></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Martin</surname><given-names>M</given-names></name></contrib></contrib-group><aff>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</aff><pub-date pub-type="ppub"><month>2</month><year>1993</year></pub-date><pub-date pub-type="epub"><day>1</day><month>2</month><year>1993</year></pub-date><volume>56</volume><volume-id pub-id-type="other">56</volume-id><volume-id pub-id-type="other">56</volume-id><issue>2</issue><issue-id pub-id-type="other">jnnp;56/2</issue-id><issue-id pub-id-type="other">2</issue-id><issue-id pub-id-type="other">56/2</issue-id><fpage>188</fpage><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-56-188.pdf"></self-uri><abstract><p>The clinical characteristics and neuropathological findings of 22 organ transplant recipients with CNS aspergillosis were reviewed. Thirteen patients had liver, six kidney, two heart and one had cluster transplants. The most frequent neurological symptoms were alteration of mental status (86%), seizures (41%) and focal neurological deficits (32%). Meningeal signs were less common (19%). Aspergillus spp invasion of the blood vessels with subsequent ischaemic or haemorrhagic infarcts, and solitary or multiple abscesses were the predominant neuropathological findings. The lungs were the probable portal of entry; however, isolated CNS aspergillosis was seen in two patients. Antemortem diagnosis of the infection was made in half of the patients. Concomitant diabetes mellitus was noted in 59% of the patients and bacterial or other severe infections in 86%. No specific clinical or pathological pattern could be identified among patients with different types of organ transplants. In addition CNS aspergillosis was preceded by organ rejection and the need for intense immunosuppression and retransplantation in the majority of the patients.</p></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>CNS aspergillosis in organ transplantation: a clinicopathological study.</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>CNS aspergillosis in organ transplantation: a clinicopathological study.</title></titleInfo><name type="personal"><namePart type="given">J</namePart><namePart type="family">Torre-Cisneros</namePart><affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">O L</namePart><namePart type="family">Lopez</namePart><affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S</namePart><namePart type="family">Kusne</namePart><affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A J</namePart><namePart type="family">Martinez</namePart><affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">T E</namePart><namePart type="family">Starzl</namePart><affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">R L</namePart><namePart type="family">Simmons</namePart><affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M</namePart><namePart type="family">Martin</namePart><affiliation>Presbyterian University Hospital, University of Pittsburgh, School of Medicine, Pennsylvania.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">1993-02</dateIssued><dateCreated encoding="w3cdtf">1993-02-01</dateCreated><copyrightDate encoding="w3cdtf">1993</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract lang="en">The clinical characteristics and neuropathological findings of 22 organ transplant recipients with CNS aspergillosis were reviewed. Thirteen patients had liver, six kidney, two heart and one had cluster transplants. The most frequent neurological symptoms were alteration of mental status (86%), seizures (41%) and focal neurological deficits (32%). Meningeal signs were less common (19%). Aspergillus spp invasion of the blood vessels with subsequent ischaemic or haemorrhagic infarcts, and solitary or multiple abscesses were the predominant neuropathological findings. The lungs were the probable portal of entry; however, isolated CNS aspergillosis was seen in two patients. Antemortem diagnosis of the infection was made in half of the patients. Concomitant diabetes mellitus was noted in 59% of the patients and bacterial or other severe infections in 86%. No specific clinical or pathological pattern could be identified among patients with different types of organ transplants. In addition CNS aspergillosis was preceded by organ rejection and the need for intense immunosuppression and retransplantation in the majority of the patients.</abstract><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>1993</date><detail type="volume"><caption>vol.</caption><number>56</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>188</start></extent></part></relatedItem><identifier type="istex">1146B1CB51D6F0DFCE9B7736F8DC5DDA73BEA65E</identifier><identifier type="ark">ark:/67375/NVC-9H5B1DTS-L</identifier><identifier type="DOI">10.1136/jnnp.56.2.188</identifier><identifier type="href">jnnp-56-188.pdf</identifier><identifier type="PMID">8437008</identifier><identifier type="local">jnnp;56/2/188</identifier><accessCondition type="use and reproduction" contentType="copyright">© British Medical Journal Publishing Group</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</recordContentSource><recordOrigin>© British Medical Journal Publishing Group</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/document/1146B1CB51D6F0DFCE9B7736F8DC5DDA73BEA65E/metadata/json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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