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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Central Nervous System Fungal Infection-Related Stroke: A Descriptive Study of Mold and Yeast-Associated Ischemic Stroke
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Central Nervous System Fungal Infection-Related Stroke: A Descriptive Study of Mold and Yeast-Associated Ischemic Stroke

机译：中枢神经系统真菌感染相关的中风：模具和酵母相关缺血性卒中的描述性研究

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Objective: Central nervous system (CNS) ischemic events caused by fungal infec-tions are rare, and clinical characteristics of these ischemic events are largely unknown. The objective of this manuscript is to highlight characteristics of fungal -related strokes and describe possible mechanistic differences between CNS mold and yeast infection-related strokes. Methods: We report a single-center retrospective case series of all adult patients who presented with concurrent CNS fungal infection and stroke between 2010 and 2018. Patients believed to have a stroke etiology due to cardioembolic, atheroembolic, or strokes nontemporally associated with a CNS fungal infection and those with incomplete stroke workups were excluded from analysis. Results: Fourteen patients were identified with ischemic stroke and concur-rent CNS fungal infection without other known ischemic stroke etiology. Eight patients had a CNS yeast infection, and 6 had a CNS mold infection. All patients presented with recurrent or progressive stroke symptoms. Six patients were immune-compromised. Four patients admitted to intravenous drug use. All yeast infections were identified by cerebrospinal fluid culture or immunologic studies while all but one of the mold infections required identification by tissue biopsy. Leptomeningeal enhancement was only associated with CNS yeast infections, while basal ganglia stroke was only associated with CNS mold infections. Conclusion: Ischemic stroke secondary to CNS fungal infections should be considered in patients with recurrent or progressive cryptogenic stroke, regardless of immune sta-tus and cerebrospinal fluid profile. CNS yeast and mold infections have slightly dif-ferent stroke and laboratory characteristics and should have a distinct diagnostic method. Depending on clinical suspicion, a thorough diagnostic approach includ-ing spinal fluid analysis and biopsy should be considered.
机译：目的：由真菌感染引起的中枢神经系统（CNS）缺血性事件非常罕见，这些缺血性事件的临床特征尚不清楚。这篇手稿的目的是强调真菌相关中风的特点，并描述中枢神经系统霉菌和酵母感染相关中风之间可能存在的机制差异。方法：我们报告了一个单中心回顾性病例系列，包括2010年至2018年期间并发CNS真菌感染和中风的所有成年患者。被认为因心脏栓塞、动脉粥样硬化栓塞或与中枢神经系统真菌感染非暂时性相关的中风病因的患者，以及中风检查不完整的患者被排除在分析之外。结果：14例患者被确诊为缺血性中风，并伴有中枢神经系统真菌感染，而无其他已知的缺血性中风病因。8名患者患有中枢神经系统酵母菌感染，6名患者患有中枢神经系统霉菌感染。所有患者均出现复发或进展性中风症状。6名患者免疫功能受损。四名患者因静脉注射药物而入院。所有酵母感染均通过脑脊液培养或免疫学研究进行鉴定，而除一种霉菌感染外，所有霉菌感染均需通过组织活检进行鉴定。软脑膜强化仅与CNS酵母感染相关，而基底节卒中仅与CNS霉菌感染相关。结论：无论免疫状态和脑脊液状况如何，反复或进行性隐源性卒中患者应考虑继发于CNS真菌感染的缺血性卒中。中枢神经系统酵母菌和霉菌感染有轻微不同的中风和实验室特征，应该有不同的诊断方法。根据临床怀疑，应考虑彻底的诊断方法，包括脊髓液分析和活检。

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