Multiple brain abscesses due to Penicillium spp infection

• Published in: Revista do Instituto de Medicina Tropical de São Paulo Vol. 47; no. 3; pp. 167 - 170
• Main Authors: Noritomi, Danilo Teixeira, Bub, Guilherme Linhares, Beer, Idal, da Silva, Aloísio Souza Felipe, de Cleva, Roberto, Gama-Rodrigues, Joaquim José
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Instituto de Medicina Tropical de Sao Paulo 01.05.2005; Instituto de Medicina Tropical
• Subjects: Adult; Amphotericin B - therapeutic use; Antifungal Agents - therapeutic use; Brain Abscess - diagnosis; Brain Abscess - drug therapy; Brain Abscess - microbiology; Central Nervous System Fungal Infections - diagnosis; Central Nervous System Fungal Infections - drug therapy; Central Nervous System Fungal Infections - microbiology; Fatal Outcome; Humans; Magnetic Resonance Imaging; Male; Penicillium - isolation & purification; Tomography, X-Ray Computed; TROPICAL MEDICINE; Penicillium spp; CNS infection; Penicilliosis; Fungal infection
• ISSN: 0036-4665; 1678-9946; 0036-4665; 1678-9946
• DOI: 10.1590/s0036-46652005000300010

We present a case of central nervous system (CNS) infection by a member of the Penicillium genera in a HIV-negative man in Brazil. The patient was admitted complaining of loss of visual fields and speech disturbances. CT scan revealed multiple brain abscesses. Stereotactic biopsies revealed fungal infection and amphotericin B treatment begun with initial improvement. The patient died few days later as a consequence of massive gastrointestinal bleeding due to ruptured esophageal varices. The necropsy and final microbiologic analyses disclosed infection by Penicillium sp. There are thousands of fungal species of the Penicillium genera. Systemic penicilliosis is caused by the P. marneffei and was formerly a rare disease, but now is one of the most common opportunistic infection of AIDS patients in Southeast Asia. The clinical presentation usually involves the respiratory system and the skin, besides general symptoms like fever and weight loss. Penicillium spp infection caused by species other than P. marneffei normally cause only superficial or allergic disease but rare cases of invasive disease do occur. We report the fourth case of Penicillium spp CNS infection.