Fungal encephalitis following bone marrow transplantation: Clinical findings and prognosis

Background: Central nervous system fungal infections (FI) are important complications and a cause of mortality in patients who receive hematopoietic stem cell transplantation (HSCT). Aims: To study the clinical aspects of fungal encephalitis (FE). Settings and Design: The study was carried out at th...

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Bibliographic Details
Published in:Journal of postgraduate medicine (Bombay) 2008-07, Vol.54 (3), p.203-205
Main Authors: Teive, HAG, Carsten, ALM, Iwamoto, FM, Almeida, SM, Munhoz, RP, Werneck, LC, Medeiros, CR, Pasquini, R
Format: Article
Language:English
Subjects:
Allogeneic hematopoietic stem cell transplantation, A spergillus sp, central nervous system infection, fungal encephalitis, mucormycosis
Bone marrow
Care and treatment
Complications and side effects
Diagnosis
Encephalitis
Medical treatment
Mortality
Risk factors
Transplantation
Transplants & implants
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Summary:Background: Central nervous system fungal infections (FI) are important complications and a cause of mortality in patients who receive hematopoietic stem cell transplantation (HSCT). Aims: To study the clinical aspects of fungal encephalitis (FE). Settings and Design: The study was carried out at the HSCT Center of the Hospital de Clνnicas, Federal University of Paranα, Curitiba, Brazil. Materials and Methods: Clinical records and autopsy reports from patients submitted to HSCT with a diagnosis of FE. Results: Twelve patients were diagnosed with FE presenting with lowered level of consciousness, hemiparesis and seizures. We were able to identify two subgroups regarding susceptibility to FE: (1) patients with early onset FI and severe leucopoenia, and (2) patients with later onset FI with graft-versus-host disease using immunosuppressive drugs. Eleven of the patients died directly due to the neurological complication, all had post-mortem confirmation of the diagnosis of FI. Conclusions: These clinical, paraclinical and temporal patterns may provide the opportunity for earlier diagnosis and interventions.
ISSN:0022-3859
0972-2823
DOI:10.4103/0022-3859.41802