Title :

Cerebral mucormycosis: neuroimaging findings and histopathological correlation.

Author(s) :

Lersy, François [Auteur]
Royer-Leblond, Julie [Auteur]
Lhermitte, Benoit [Auteur]
Chammas, Agathe [Auteur]
Schneider, Francis [Auteur]
Hansmann, Yves [Auteur]
Lefebvre, Nicolas [Auteur]
Denis, Julie [Auteur]
Sabou, Marcela [Auteur]
Lafitte, François [Auteur]
Cotton, François [Auteur]
Boncoeur-Martel, Marie-Paule [Auteur]
Tourdias, Thomas [Auteur]
Pruvo, Jean-Pierre [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Cottier, Jean-Philippe [Auteur]
Herbrecht, Raoul [Auteur]
Kremer, Stéphane [Auteur]

Journal title :

Journal of Neurology

Abbreviated title :

J Neurol

Volume number :

269

Pages :

1386–1395

Publication date :

2021-07-08

ISSN :

1432-1459

English keyword(s) :

Fungal
Invasive fungal infections
Mucormycosis
Cerebral mucormycosis
MRI

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Introduction Mucormycosis are infections caused by molds of the order Mucorales. These opportunistic infections are rare, difficult to diagnose, and have a poor prognosis. We aimed to describe common radiographic patterns ...
Show more >Introduction Mucormycosis are infections caused by molds of the order Mucorales. These opportunistic infections are rare, difficult to diagnose, and have a poor prognosis. We aimed to describe common radiographic patterns that may help to diagnose cerebral mucormycosis and search for histopathological correlations with imaging data. Methods We studied the radiological findings (CT and MRI) of 18 patients with cerebral mucormycosis and four patients’ histopathological findings. Results All patients were immunocompromised and/or diabetic. The type of lesions depended on the infection’s dissemination pathway. Hematogenous dissemination lesions were most frequently abscesses (59 lesions), cortical, cortical–subcortical, or in the basal ganglia, with a halo aspect on DWI for lesions larger than 1.6 cm. Only seven lesions were enhanced after contrast injection, with different presentations depending on patients’ immune status. Ischemia and hemorrhagic areas were also seen. Vascular lesions were represented by stenosis and thrombosis. Direct posterior extension lesions were bi-fronto basal hypodensities on CT and restricted diffusion without enhancement on MRI. A particular extension, perineural spread, was seen along the trigeminal nerve. Histopathological analysis found endovascular lesions with destruction of vessel walls by Mucorales, microbleeds around vessels, as well as acute and chronic inflammation. Conclusions MRI is the critical exam for cerebral mucormycosis. Weak ring enhancement and reduced halo diffusion suggest the diagnosis of fungal infections. Involvement of the frontal lobes should raise suspicion of mucormycosis (along with aspergillosis). The perineural spread can be considered a more specific extension pathway of mucormycosis.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Lille Neurosciences & Cognition (LilNCog) - U 1172

Submission date :

2024-06-22T22:19:17Z
2024-11-25T13:11:24Z
2024-11-25T13:13:52Z