[Case study] One case of intracranial fungal infection

Female, 10 years old
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Pathological diagnosis: granulomatous inflammation, combined with special staining, the mycelium PAS (+) hyphae are detected, considered fungal granulomas
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[General]

Intracranial fungal infections are mostly chronic or subacute, the onset is insidious, the early systemic response is not obvious, and the symptoms and signs of intracranial hypertension and neurolocalization that appear later are not significant, and clinical diagnosis is difficult
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[Pathological basis and imaging findings]
A: fungal encephalitis pathological changes are mainly brain manifestations of a large number of serous effusions from the bottom of the brain, significant thickening of the meninges and choroid plexus, mainly characterized by inflammatory exudation of the subbead omentum space, which can be accompanied by the formation of small nodules in the cortex, 40% of fungal meningitis CT does not show no specificity, similar to tuberculous meningitis, chronic cases can see hydrocephalus
。 MRI findings are similar to CT, with reports that MRI enhancement is more likely to distinguish between abnormal strengthening of the pivomeninges of brain manifestations, slightly higher intra-t1WI intra-brain-pool sulcus, higher T2WI, more pronounced foci of the water suppression sequence, significantly strengthened posterior cistern sulcus, and difficulty in distinguishing from tuberculous meningitis, but if irregular small classes of dotted calcification are found in the saddle area or saddle, high-density shadows are helpful in diagnosis
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Two: fungal granuloma or abscess Fungal brain abscess accounts for 1.