The Experts below are selected from a list of 1965 Experts worldwide ranked by ideXlab platform
Jiang Qian - One of the best experts on this subject based on the ideXlab platform.
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september 2004 a 6 year old girl with headache and stiff neck
Brain Pathology, 2006Co-Authors: Qing Li, Xiao He Yang, Jiang QianAbstract:CASE OF THE MONTH: ABSTRACT September 2004. Free-living amebas in the genera Naegleria, Acanthamoeba and Balamuthia are known to cause CNS infections. Here we report a case of fatal granulomatous amebic meningoencephalitis (GAE) caused by Balamuthia mandrillaris in a 6-year-old previously healthy girl who presented with headache and stiff neck. She was treated medically for brain abscess after a CT scan identified a Ring-Enhancing Lesion in the right temporo-parietal area. A brain biopsy showed necrosis and granulomatous inflammation. Subsequently, multiple new Lesions appeared in the brain bilaterally. A second brain biopsy revealed viable amebic trophozoites that were most abundant in perivascular spaces, accompanied by neutrophils, macrophages and eosinophils. Immunofluorescence study confirmed the amoeba as Balamuthia mandrillaris. This case demonstrates that making diagnosis of GAE pre-mortem requires a high index of suspicion. Amebic infection should be included in the differential diagnosis of any granulomatous Lesion in CNS; and careful search for amebic parasites should be carried out especially when necrosis predominates in the pathological material.
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SEPTEMBER 2004: A 6‐YEAR‐OLD GIRL WITH HEADACHE AND STIFF NECK
Brain Pathology, 2006Co-Authors: Qing Li, Xiao He Yang, Jiang QianAbstract:CASE OF THE MONTH: ABSTRACT September 2004. Free-living amebas in the genera Naegleria, Acanthamoeba and Balamuthia are known to cause CNS infections. Here we report a case of fatal granulomatous amebic meningoencephalitis (GAE) caused by Balamuthia mandrillaris in a 6-year-old previously healthy girl who presented with headache and stiff neck. She was treated medically for brain abscess after a CT scan identified a Ring-Enhancing Lesion in the right temporo-parietal area. A brain biopsy showed necrosis and granulomatous inflammation. Subsequently, multiple new Lesions appeared in the brain bilaterally. A second brain biopsy revealed viable amebic trophozoites that were most abundant in perivascular spaces, accompanied by neutrophils, macrophages and eosinophils. Immunofluorescence study confirmed the amoeba as Balamuthia mandrillaris. This case demonstrates that making diagnosis of GAE pre-mortem requires a high index of suspicion. Amebic infection should be included in the differential diagnosis of any granulomatous Lesion in CNS; and careful search for amebic parasites should be carried out especially when necrosis predominates in the pathological material.
Qing Li - One of the best experts on this subject based on the ideXlab platform.
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september 2004 a 6 year old girl with headache and stiff neck
Brain Pathology, 2006Co-Authors: Qing Li, Xiao He Yang, Jiang QianAbstract:CASE OF THE MONTH: ABSTRACT September 2004. Free-living amebas in the genera Naegleria, Acanthamoeba and Balamuthia are known to cause CNS infections. Here we report a case of fatal granulomatous amebic meningoencephalitis (GAE) caused by Balamuthia mandrillaris in a 6-year-old previously healthy girl who presented with headache and stiff neck. She was treated medically for brain abscess after a CT scan identified a Ring-Enhancing Lesion in the right temporo-parietal area. A brain biopsy showed necrosis and granulomatous inflammation. Subsequently, multiple new Lesions appeared in the brain bilaterally. A second brain biopsy revealed viable amebic trophozoites that were most abundant in perivascular spaces, accompanied by neutrophils, macrophages and eosinophils. Immunofluorescence study confirmed the amoeba as Balamuthia mandrillaris. This case demonstrates that making diagnosis of GAE pre-mortem requires a high index of suspicion. Amebic infection should be included in the differential diagnosis of any granulomatous Lesion in CNS; and careful search for amebic parasites should be carried out especially when necrosis predominates in the pathological material.
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SEPTEMBER 2004: A 6‐YEAR‐OLD GIRL WITH HEADACHE AND STIFF NECK
Brain Pathology, 2006Co-Authors: Qing Li, Xiao He Yang, Jiang QianAbstract:CASE OF THE MONTH: ABSTRACT September 2004. Free-living amebas in the genera Naegleria, Acanthamoeba and Balamuthia are known to cause CNS infections. Here we report a case of fatal granulomatous amebic meningoencephalitis (GAE) caused by Balamuthia mandrillaris in a 6-year-old previously healthy girl who presented with headache and stiff neck. She was treated medically for brain abscess after a CT scan identified a Ring-Enhancing Lesion in the right temporo-parietal area. A brain biopsy showed necrosis and granulomatous inflammation. Subsequently, multiple new Lesions appeared in the brain bilaterally. A second brain biopsy revealed viable amebic trophozoites that were most abundant in perivascular spaces, accompanied by neutrophils, macrophages and eosinophils. Immunofluorescence study confirmed the amoeba as Balamuthia mandrillaris. This case demonstrates that making diagnosis of GAE pre-mortem requires a high index of suspicion. Amebic infection should be included in the differential diagnosis of any granulomatous Lesion in CNS; and careful search for amebic parasites should be carried out especially when necrosis predominates in the pathological material.
Francisco M Marty - One of the best experts on this subject based on the ideXlab platform.
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fonsecaea monophora cerebral phaeohyphomycosis case report of successful surgical excision and voriconazole treatment and review
Medical Mycology, 2010Co-Authors: Sophia Koo, Michael Klompas, Francisco M MartyAbstract:We report a case of Fonsecaea monophora cerebral phaeohyphomycosis successfully treated with surgical excision and voriconazole monotherapy in a patient receiving maintenance immunosuppression therapy for 8 years after cadaveric renal transplantation. She presented with a severe frontal headache in the absence of any constitutional or neurologic symptoms. Brain magnetic resonance imaging showed an irregular 3.1 × 3.4 cm Ring-Enhancing Lesion in her left frontal lobe. The patient underwent craniotomy and resection of her mass, with intraoperative spillage of some of her abscess contents into her lateral ventricle. Histopathology of her resected mass showed necrotic fragments of brain parenchyma with granulomatous inflammation and numerous pigmented fungal forms. A mold, recovered from cultures inoculated with portions of her brain resection specimen, was later definitively identified as Fonsecaea monophora. Initial serum (1→3) β-D-glucan (BG) levels exceeded 500 pg/ml. The patient received voriconazole, wh...
Karen Roos - One of the best experts on this subject based on the ideXlab platform.
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Focal seizures with single small Ring-Enhancing Lesion
Seminars in Pediatric Neurology, 1999Co-Authors: Pratibha Singhi, Karen RoosAbstract:An 8-year-old girl presented with simple partial seizures. The differential diagnosis and evaluation point out the fact that in most of the world, conditions considered rare in the United States are important diagnostic considerations.
Lester Kwock - One of the best experts on this subject based on the ideXlab platform.
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Magnetic resonance imaging and spectroscopy of small Ring-Enhancing Lesions using a rat glioma model.
Investigative radiology, 1994Co-Authors: Michael Gill, Sandra L. Miller, David Evans, James H. Scatliff, Mary E. Meyerand, Stephen K. Powers, Lester KwockAbstract:RATIONALE AND OBJECTIVES We sought to demonstrate the usefulness of proton and fluorine magnetic resonance spectroscopy (MRS) techniques in characterizing small ring enhancing Lesions produced by experimental malignant gliomas. METHODS The growth characteristics of a rat glioma model (RT2) were studied using contrast-enhanced magnetic resonance imaging scans of the tumors and histologic correlates obtained at various times. Changes in tumor metabolite levels were monitored on a serial basis using water-suppressed proton spectroscopy. The existence of tumor hypoxia was established using 19F MRS in combination with a fluorinated nitroimidazole and subsequently confirmed by immunohistochemical staining of tumor sections. RESULTS Ring-Enhancing Lesions are produced by RT2 rat brain gliomas approximately 7 days after intracerebral implantation. Beginning at day 5, marked deviations in brain metabolite levels are observed on proton MR spectra. However, while the signal from the fluorinated nitroimidazole is first detected by 19F MRS at day 7, immunohistochemical staining of tissue sections reveals bound drug as early as day 5, when the first histologic signs of necrosis become apparent. CONCLUSIONS Magnetic resonance imaging of RT2 rat brain glioma exhibits Ring-Enhancing characteristics similar to those observed in clinical studies. The appearance of the ring enhancement corresponds with the development of central necrosis and could serve as an indicator for rapid growth. Proton and fluorine MRS may be useful in confirming that a small Ring-Enhancing Lesion represents an active tumor process early in its development.
