Abstract
Cerebral mycosis is a rare condition, difficult to diagnose in life, but is not easily missed at postmortem examination. We report clinical and pathological findings in four patients with long duration prodromes, seizures and psychiatric symptoms. All of them had been misdiagnosed. Actinomycotic granules in two and Aspergillus filaments in the other patients were ascertained at histological examination. Two of the patients were in their twenties and apparently healthy. We suggest that the possibility of mycotic infection should be considered even in cases where no lowering of the body's defences can be postulated. Cell mediated immunity defects may be assumed as underlying these infections. Therefore we would suggest the importance of immunological tests for type IV immune responsiveness in all intracranial infective processes of undefined etiology.
Sommario
Le micosi cerebrali sono affezioni rare, difficili da diagnosticare, ma tali da non sfuggire facilmente all'esame autoptico.
Noi riferiamo i dati clinici e patologici di quattro pazienti che avevano presentato crisi epilettiche e sintomatologia psichiatrica. Per nessuno era stata posta diagnosi esatta. I granuli actinomicotici in due pazienti ed i filamenti dell'Aspergillo nei restanti furono scoperti nel corso dell'indagine istopatologica di routine.
Due dei pazienti avevano circa vent'anni e sembravano godere di buona salute. A nostro avviso la possibilità di una infezione micotica andrebbe sempre tenuta presente, anche quando non sia il caso di pazienti nei quali un abbassamento dei cosidetti poteri di difesa dell'organismo sia dato per scontato. È postulabile che vi siano dei disordini latenti a carico della immunità cellulomediata. Per questo motivo riterremmo importante compiere indagini immunologiche su questo versante davanti a processi infettivi endocranici ad agente eziologico incerto.
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Bettoni, L., Gabrielli, M., Lechi, A. et al. Cerebral mycosis: Clinico-pathological report of four cases observed in fifteen months. Ital J Neuro Sci 5, 437–443 (1984). https://doi.org/10.1007/BF02042629
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DOI: https://doi.org/10.1007/BF02042629