Fungal encephalitis following bone marrow transplantation: clinical findings and prognosis.

Abstract

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 Clínicas, Federal University of Paraná, 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 leucopenia, 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.

• Authors: Hag Teive, A L M Carsten, F M Iwamoto, S M Almeida, R P Munhoz, L C Werneck, C R Medeiros, R Pasquini
• Journal: Journal of postgraduate medicine (J Postgrad Med) 2008 Jul-Sep Vol. 54 Issue 3 Pg. 203-5 ISSN: 0972-2823 [Electronic] India
• PMID: 18626168 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Brazil
• Central Nervous System Fungal Infections (complications, etiology, immunology)
• Child
• Child, Preschool
• Encephalitis (complications, immunology)
• Female
• Graft vs Host Disease (etiology, immunology, mortality)
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Male
• Middle Aged
• Prognosis
• Retrospective Studies
• Transplantation Conditioning (adverse effects)
• Young Adult