A 26-year-old woman currently treated for systemic lupus erythematosus with steroid therapy presented with sudden onset of right hemiplegia. Computed tomography of the brain showed a large frontoparietal ring-enhanced lesion with perifocal edema. Stereotactic aspiration of the lesion revealed Cladosporium bantianum. The size of the abscess did not reduce in spite of optimum antifungal treatment. The abscess was subsequently excised through a frontoparietal craniotomy. At follow up after 24 months, there was no recurrence of the abscess. Cerebral Cladosporium bantianum infection is usually refractory to antifungal agents and the prognosis is very poor. This patient had the longest survival period in a case of Cladosporium brain abscess so far reported.

译文

一名26岁的妇女目前接受类固醇治疗的系统性红斑狼疮,表现为右偏瘫突然发作。大脑的计算机断层扫描显示大额顶环形增强病变并伴有病灶周围水肿。病变的立体定向抽吸显示为bantianum枝孢菌。尽管进行了最佳的抗真菌治疗,但脓肿的大小并未减少。随后通过额顶开颅手术切除脓肿。24个月后随访,无脓肿复发。bantianum脑枝孢菌感染通常对抗真菌药物难治,预后很差。该患者在迄今为止报道的枝孢菌性脑脓肿病例中生存期最长。

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