This report describes a rapidly fatal case of cerebral phaeohyphomycosis in a 33-year-old immunocompetent male. The infection presented as a single large lesion in the deep white matter of one temporal lobe, which was then removed surgically. Histologic features observed in the lobectomy specimen were characterized by perivascular sleeves of mononuclear cells accompanied by hemorrhages. These were reminiscent of acute hemorrhagic leukoencephalitis except for the presence of rare fungal organisms and sparse multinucleated giant cells similar to those occurring in AIDS. During the four days following surgery, a large focus of cerebritis with massive invasion of fungi developed in each centrum semiovale around the ventriculostomy sites. Fungal culture of the brain obtained at autopsy grew an organism consistent with a Scopulariopsis species.

Adult↗

PubMedDate not supplied

Experimental production of arachnoiditis with glove powder contamination during myelography.

Adhesive spinal arachnoiditis is a rare condition of several causes, including complications of myelography. An experiment was conducted to study the effects of surgical glove powder contamination in the cerebrospinal fluid. The subarachnoid space of 45 rabbits was injected with either a suspension of powder from sterile surgical gloves, Pantopaque (iophendylate), or a combination of the two agents. Mild to severe arachnoiditis was produced in 10 of 17 animals injected with the combination of powder and Pantopaque. Only two of 16 rabbits injected with glove powder and one of nine with Pantopaque had more than minimal changes of arachnoiditis. Three rabbits (two injected with glove powder alone and one with both agents) died of meningitis within 1 week of injection. The combination of glove powder and Pantopaque is synergistic in producing arachnoiditis. These results emphasize the importance of meticulous technique in myelography.

Animals↗

PubMedDate not supplied

Pure thalamic dementia with a single focus of spongiform change in cerebral cortex.

An absence of spongiform change differentiates the pure thalamic degeneration (PTD) from the thalamic form of Creutzfeldt Jakob Disease (CJD). This report describes a case which in addition to the neuropathological changes typical of primary thalamic degeneration showed a single small focus of spongiform change in the cerebral cortex. The exceptional instances of thalamic degeneration associated with limited spongiform change among which this case is unique by virtue of the size of the single focus of vacuolation probably represent a variant of the thalamic form of CJD. In the context of potential infectious etiology the fact that the patient had a blood transfusion five months before the onset of neurological illness is of interest.

Brain Stem↗