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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 56-year-old man with diabetes mellitus and alcoholic liver cirrhosis was admitted on an emergency basis to our hospital for further examination of headache, general fatigue and dysarthria. He had been treated with antifungal drugs on the suspicion of pulmonary mycosis. Brain MRI revealed multiple cerebellar abscesses with ring enhancement. Due to depression of mental status despite medical treatment, he underwent suboccipital craniotomy and enucleation of the cerebellar abscess, resulting in marked improvement of consciousness level. As the culture of his abscess content yielded Nocardia farcinica, the definite diagnosis of Nocardial cerebellar abscesses and pulmonary Nocardiosis were made. Pulmonary Nocardiosis improved by oral co-trimoxazole treatment. Moreover, no recurrence of cerebellar abscesses was evident. This case indicates that the possibility of Nocardial infection should be considered in the immuno-compromised hosts.
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PMID:[Pulmonary nocardiosis complicated with multiple cerebellar abscess]. 1919 10

Clinic, epidemiological and microbiological characteristics of 128 episodes of cryptococcosis were retrospectively evaluated in 106 positive HIV patients hospitalized at the Paroissien Hospital on period 1996-2007. There were 75 male and 31 female patients, with a median age of 34 years, ranging from 20 to 68 years. Addiction to intravenous drugs was the main cause of HIV infection in 55 patients (51.9%). Cryptococcosis was detected as single episode in 85 patients (80.2%) and as relapse in 19 (17.9%). It appeared as the first marking disease in 36 patients (34.0%). Diagnosis was established in 116 episodes by CSF study (Indian ink, culture, antigen detection), in 9 cases by Cryptococcus sp. recovery from blood cultures, and in 3 cases by antigen detection in patient's serum with a latex reactive. Neurological symptomatology, with headache and fever as the most common signs, was presented by 89.6% of patients. Induction treatment was done in all cases with amphotericin B, and maintenance treatment was carried out with fluconazole. Mortality rate was 35.8%, being higher in those patients who had suffered relapses (41.3%) compared to those who presented a first episode of the mycosis (33.3%).
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PMID:[Cryptococcosis in AIDS patients: case study from 1996 to 2006 in Paroissien Hospital]. 1921 44

A 28-year-old Pakistani man was admitted with unresolved severe headaches for the past four weeks. Magnetic resonance (MR) imaging and MR angiography showed an enhancing mass in the sphenoid sinus, bilateral cerebellar infarcts and aneurysmal dilatation of the basilar artery. The differential diagnosis included fungal infection versus neoplastic lesion. The scrappings taken through the endoscope from the sphenoid sinus were initially negative for fungal infection. However, the second biopsy, done after putting him on antifungal, itraconazole 200 mg twice daily, revealed the presence of a fungal infection (aspergillosis). MR imaging revealed extension of the fungal infection from the sphenoid sinus into the clivus, and then intracranially. Imaging also revealed aneurysmal dilatation of the basilar artery and infarctions in the cerebellum and subarachnoid haemorrhage. Despite aggressive antifungal treatment, the patient died after 29 days. This case report describes the probable mechanism of fungal mycotic aneurysmal vascular dilatation and growth. It also points to the need for a rapid diagnosis of potential cases and an aggressive treatment approach of confirmed cases of fungal infections of the central nervous system.
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PMID:Cerebral fungal infection with mycotic aneurysm of basilar artery and subarachnoid haemorrhage. 1922 64

Moulds are responsible for diseases in humans through the three pathogenetic mechanisms of infection, allergy, and toxicity. Fungal infection is especially a risk factor for immunodeficient patients, but it occurs in immunocompetent patients as well. Fungal allergy is manifested as bronchial asthma, hypersensitivity pneumonitis, allergic bronchopulmonary aspergillosis, or allergic fungal sinusitis. Mycotoxicosis is almost exclusively the result of ingestion of mould-contaminated foodstuffs. In each case there is specificity for the etiologic mould. There is controversy regarding the ability of indoor airborne mould spores to cause human disease through non-specific toxicity via the inhalation route. Pulmonary mycotoxicosis is an established, although rare, occupational disease of farmers who inhale enormous quantities of mycotoxins, endotoxins, and other toxic chemicals from contaminated silage. Other conditions attributed to indoor airborne mycotoxin are unproven. These include infantile pulmonary hemosiderosis, epistaxis, 'toxic encephalopathy', immune dysregulation and a variety of subjective complaints without objective signs of pathology such as fatigue, headache, dyspnea, gastrointestinal distress, neuromuscular and skeletal complaints, etc. Non-specific irritation from moulds via the inhalation route is also a controversial subject that remains unproven. Published studies alleging an epidemiologic causal relationship are unconvincing.
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PMID:Sick Building Syndrome: is mould the cause? 1925 24

Fungal infections are rare but represent serious complications following organ transplantation. We present a case of mucormycosis primarily affecting the paranasal sinuses in a 51-year-old man with a kidney allograft. The patient presented with headache, left facial and orbital pain, nasal discharge, and elevation of serum creatinine 18 months after kidney transplantation. Laboratory tests revealed cyclosporine nephrotoxicity, cytomegalovirus infection, and prediabetes. Imaging findings were compatible with left maxillary, ethmoidal, and sphenoidal sinusitis. Diagnosis was made based on pathologic findings and detection of typical fungal hyphea in the infected tissues. The patient was successfully treated by discontinuation of cyclosporine and mycophenolate mofetil, initiation of systemic amphotericin B, and aggressive surgical debridement.
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PMID:Successful treatment of mucormycosis after kidney transplantation. 1937 32

Cerebral phaeohyphomycosis is a fungal infection of the brain typically caused by Cladophialophora bantiana, Exophiala dermatitidis, and Rhinocladiella mackenziei, all of which belong to the order Chaetothyriales. The disease results in black, necrotic brain tissue, black pus, and black cerebrospinal fluid. Pathogens usually reach the brain through the bloodstream or lymphatic fluid and occasionally through direct spreading or accidental inoculation. Patients can present with hemiparesis, tonic spasm, headache, fever, sensory variation, cerebral irritation, and even psychotic behavioural changes. Radiological images are characterised by ring-enhanced signs and hyperdense and hypodense lesions. Pathological features frequently include black-to-brown necrotic tissue or dark-coloured pus, granulomatous inflammation, giant cell vasculitis, and pigmented fungal elements, which are easily seen on a direct potassium hydroxide smear, a rapid method for diagnosis. Black fungi can be cultured from a biopsy specimen. Combined antifungal chemotherapy, surgical debridement, and careful immunological interventions are strongly recommended to eradicate these intractable infections.
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PMID:Cerebral phaeohyphomycosis--a cure at what lengths? 1946 77

The case of a 9-year-old boy is presented in this article who developed a rare fungal infection of central nervous system. The histopathologic examination has revealed mucormycosis. The diagnosis wasn't confirmed microbiologically as the culture and PCR were negativ. After the iv administered Amphotericin B lipid complex the MR images of the brain have improved. The mucormycosis classically develops in immunodeficient patients and presents an acute, fulminant, mostly lethal infection. This case is very unusual, because the chronic, isolated CNS mucormycosis has slowly developed in immuncompetent patient and only one symptom was the long existing headache. The aim of this paper is reporting the case history and to find out the possible way of infection.
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PMID:[Non-obstructive hydrocephalus internus with a rare pathogenesis--mucormycosis]. 1968 6

Fungus balls are a non-invasive form of fungal infection involving the maxillary sinus in most cases. Sphenoid sinus fungus balls (SSFB) are rare and their clinical presentation is not well described. We intended to define the clinical presentation of sphenoid fungus balls, and retrospectively reviewed 24 cases of SSFB seen at our institution over a 10-year period, identified through pathological reports. Presenting symptoms were separated into three groups: headache, rhinological and asymptomatic. Headaches were subdivided into acute and chronic, unilateral and diffuse. Radiological clues leading to diagnosis were reviewed. Prognosis was determined from medical files or by phone calls. Sixty-seven per cent of patients were female. The mean age at presentation was 65 years. Sixty-two per cent presented with headache, 36% unilateral, mainly in the first trigeminal branch territory. Rhinological symptoms were seen in 21%. In 16% of patients the SSFB was asymptomatic and found during routine tests. SSFB, even if non-invasive, did lead to recurrent bacterial infections and central nervous system complications in three patients. Of 15 patients presenting with headache, 10 were significantly improved post surgery. The prognosis is good, with no recurrence of fungal infection after a main follow-up of 2.3 years. Our study underlines that SSFB present with headaches, often unilateral and in the fronto-orbital region. Proper imaging of the sphenoid sinus is useful in patients with unexplained headache. The neurologist has to be aware of radiological clues suggesting fungal sinus infection, since surgery is the main treatment, with good prognosis and frequent resolution of headaches.
Cephalalgia 2009 Nov
PMID:Sphenoid fungus balls: clinical presentation and long-term follow-up in 24 patients. 1981 5

Histoplamosis is the most common primary systemic mycosis in the USA and is becoming more common as an opportunistic infection in HIV patients worldwide. In children the rate of asymptomatic infection is high. However, in infants with an immature immunological system, disseminated disease may occur. The clinical picture is variable depending on the immunological status. At the onset of the infection clinical manifestations are non specific (headache, fever, cough and nausea). Usually, these symptoms are self-limited and improve without treatment. However, patients with disseminated diseases present with prolonged fever, malaise, cough and weight loss. Hepatosplenomegaly is frequent in infants. Chest radiographs may be normal in 40 to 50% of patients with disseminated disease but findings such as lobar or diffuse infiltrates, cavitations, hilar adenopathy, or any combination of these may be found. Frequently, the clinical presentation is misdiagnosed as tuberculosis. Skin tests, serological reaction and specific cultures are used for diagnosis confirmation. Treatment indications and regimens are similar to those for adults, except that amphotericin B deoxycholate is usually well tolerated in children.
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PMID:Histoplasmosis in children. 1987 6

Opportunistic infection is one of the important cause of graft dysfunction after organ transplantation. It usually occurs one year after post transplantation in a immunocompromised transplant recipient. Among the opportunistic infections fungal infection is important cause of graft dysfunction as well as increase morbidity and mortality of post transplant recipient. Cryptococcosis is the third most common invasive fungal infection in an organ transplant recipient next to Candidiasis and Aspergillosis. A 27 years young male is known case of live related renal allograft recipient on immunosuppression for last one and half years. Patient was admitted with irregular fever, severe headache, nausea and vomiting in the department of Nephrology on July 2007. After admission patient was thoroughly evaluated and clinically found features of meningitis. Subsequent investigation report revealed swollen of 3rd ventricle on CT scan brain and growth of Cryptococcus in CSF culture and diagnosis was made post renal transplant cryptococcal meningitis. Treatment was given with Injection Amphotericin B along with immunosuppression and other supportive measured. But inspite of treatment, within few days after diagnosis patient was underwent coma and died. In conclusion, cryptococcal meningitis is a serious invasive fungal infection in post transplant immunocompromised recipient and responsible for graft lose and increase morbidity of the transplant patients.
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PMID:Cryptococcosis in organ transplantation. 2004 89


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