Cryptococcal meningitis after transnasal transsphenoidal pituitary microsurgery of ACTH-secreting pituitary adenoma: A case report.
Rationale: Microbial infection should be regarded in the differential diagnosis of neurosurgical complications after transnasal transsphenoidal pituitary microsurgery, albeit cryptococcal meningitis is rare. This article will discuss the risk factors of cryptococcal meningitis in patients underwent...
| Publicado en: | Medicine Vol. 96; no. 28; pp. 1 - 4 |
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| Autores principales: | , , , , , , , , , , , , , |
| Formato: | case study Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Jul2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=124399625&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 124399625 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00257974 2S6 jtl: Medicine issn: 00257974 maglogo: N pubinfo: dt: Jul2017 vid: 96 iid: 28 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 124399625 124399625 NLM28700464 124399625 10.1097/MD.0000000000007124 NLM28700464 124399625 ppf: 1 ppct: 3 formats: tig: atl: Cryptococcal meningitis after transnasal transsphenoidal pituitary microsurgery of ACTH-secreting pituitary adenoma: A case report. aug: au: Yang Liu Ming Feng Yong Yao Kan Deng Xinjie Bao Xiaohai Liu Renzhi Wang Liu, Yang Feng, Ming Yao, Yong Deng, Kan Bao, Xinjie Liu, Xiaohai Wang, Renzhi affil: Department of Neurosurgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China. sug: subj: Meningitis, Cryptococcal Etiology Cryptococcosis Etiology Microsurgery Postoperative Complications ACTH-Secreting Pituitary Adenoma Surgery Adenoma Surgery Meningitis, Cryptococcal Drug Therapy Pituitary Gland Surgery Diagnosis, Differential Cryptococcosis Drug Therapy Cryptococcus Meningitis, Cryptococcal Diagnosis Cryptococcosis Diagnosis Adult Male Fatal Outcome Adult: 19-44 years Male ab: Rationale: Microbial infection should be regarded in the differential diagnosis of neurosurgical complications after transnasal transsphenoidal pituitary microsurgery, albeit cryptococcal meningitis is rare. This article will discuss the risk factors of cryptococcal meningitis in patients underwent transnasal transsphenoidal pituitary microsurgery, and summary the potential origins of infection.Patient Concerns and Diagnosis: Here, we report a case of 37-year-old male who had cryptococcal meningitis after transnasal transsphenoidal pituitary microsurgery of a relapsing ACTH-secreting pituitary adenoma.Intervention: Standard therapy for Cryptococcus neoformans (fluconazole [400 mg per day] and flucytosine) was administered and followed by maintenance dose.Outcomes: The patient had been on treatment for one and a half years during follow-up and reported neurologically well with repeated negative cerebrospinal fluid (CSF) culture until sudden death of heart arrest.Main Lessons To Learn: C neoformans can be a possible cause of meningitis in immunocompetent patients after transnasal transsphenoidal pituitary microsurgery. Risk factors, such as pre-existed pulmonary infection and Cushing-associated hypercortisolemia, should be stressed. Promising preventive measures may include preoperative routine sputum smear and India-ink stain for screening, preoperative treatment of cryptococcal pneumonia, postoperative antibiotic management, and a more secure skull base reconstruction. Radiation and pharmaceutical treatment may be alternative for recurrent Cushing disease. pubtype: Academic Journal doctype: case study Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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