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
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<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>
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<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>
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