Therapy And Diagnosis Of Phaeohyphomycosis Of Central Nervous System

Objective: To explore the clinical characteristics,diagnosis,treatment and prognosis ofphaeohyphomycosis.Methods: Clinical data collected,including history,physical examination,cranialimaging.Brain biopsy was performed.Data of the pathology and incubation of braintissue were analyzed.Responsiveness to treatment was followed up.Results: The patient was male,61years old. Trapped in continuing headache andmetamorphopsia for one week, He saw a doctor at the neurosurgery department in theaffiliated XieHe hospital of FuJian medical university.The brain MRI examinationfound a space-occupying lesion in the left parietal-occipital lobe.Then asurgery,Nerve navigationally auxiliary space-occupying lesion resection accompanyedby cranioplasty,was performed.And the pathologic report showed cerebralchromomycosis with massive necrosis and giant cell reaction.After the surgery,werefever and right homonymous hemianopia coming. Amphotericin B, an antifungalagent,was taken for treatment,during which chills and fever attacked thepatient again and again.For further therapy,The patient wastransferred to ourhospital. After administration, the first one-month theatment with Diflucan was lesseffective and it was replaced by eight-month application of Voriconazole,Duringwhich, headache got relieved and fever got eased gradually. When Voriconazole waswithdrown, only was right homonymous hemianopia left.Conclusions: Cerebral Phaeohyphomycosis caused by dematiaceous fungi is rare,butthe most serious form of fungs infection.Pathology and incubation of the tissue areessential for diagnosis.There is no curative therapy and the prognosis is poor.