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Aspergillus pachymeningitis mimicking nasopharyngeal carcinoma

Published online by Cambridge University Press:  27 September 2010

H S Chan ,
H Y Yuen ,
W K Ng ,
A C Vlantis ,
A T Ahuja ,
C F M Tong  and
C A van Hasselt
H S Chan*
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, The Chinese University of Hong Kong, China
H Y Yuen
Affiliation:
Department of Radiology and Diagnostic Imaging, The Chinese University of Hong Kong, China
W K Ng
Affiliation:
Division of Neurosurgery, Department of Surgery, The Chinese University of Hong Kong, China
A C Vlantis
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, The Chinese University of Hong Kong, China
A T Ahuja
Affiliation:
Department of Radiology and Diagnostic Imaging, The Chinese University of Hong Kong, China
C F M Tong
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, The Chinese University of Hong Kong, China
C A van Hasselt
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, The Chinese University of Hong Kong, China
*
Address for correspondence: Dr H S Chan, Department of Otorhinolaryngology Head and Neck Surgery, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR, China Fax: 852 2632 4679 E-mail: dearhs@gmail.com
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Abstract

Objectives:

We report a case of otogenic fungal pachymeningitis in a diabetic patient who presented with multiple cranial nerve palsies and nasopharyngeal swelling.

Methods:

We present a case report, we describe the investigations, management and clinical course of fungal pachymeningitis, and we present a review of the world literature on fungal and non-fungal pachymeningitis.

Results:

To our knowledge, this is the first report of fungal pachymeningitis with magnetic resonance imaging features suggestive of nasopharyngeal carcinoma. It is also the first reported case with aspergillus cultured from both a dural biopsy and the ear canal.

Conclusion:

Fungal pachymeningitis is a rare condition which may present to otorhinolaryngologists. Its clinical and radiological findings can be confused with those of nasopharyngeal carcinoma; fungal pachymeningitis should thus be included in the differential diagnosis of nasopharyngeal carcinoma.

Keywords

AspergillosisCentral Nervous System InfectionsNasopharyngeal Neoplasm
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 1 , January 2011 , pp. 103 - 107
Copyright
Copyright © JLO (1984) Limited 2010

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References

1 Kupersmith, MJ, Martin, V, Heller, G, Shah, A, Mitnick, HJ. Idiopathic hypertrophic pachymeningitis. Neurology 2004;62:686–94CrossRefGoogle ScholarPubMed
2 Hatano, N, Behari, S, Nagatani, T, Kimura, M, Ooka, K, Saito, K et al. Idiopathic hypertrophic cranial pachymeningitis: clinicoradiological spectrum and therapeutic options. Neurosurgery 1999;45:1336–42CrossRefGoogle ScholarPubMed
3 Rossi, S, Giannini, F, Cerase, A, Bartalini, S, Tripodi, S, Volpi, N et al. Uncommon findings in idiopathic hypertrophic cranial pachymeningitis. J Neurol 2004;251:548–55CrossRefGoogle ScholarPubMed
4 Murai, H, Kira, J, Kobayashi, T, Goto, I, Inoue, H, Hasuo, K. Hypertrophic cranial pachymeningitis due to Aspergillus flavus. Clin Neurol Neurosurg 1992;94:247–50CrossRefGoogle ScholarPubMed
5 Ismail, AR, Clifford, L, Meacock, WR. Compressive optic neuropathy in fungal hypertrophic cranial pachymeningitis. Eye 2007;21:568–9CrossRefGoogle ScholarPubMed
6 Iwasaki, S, Ito, K, Sugasawa, M. Hypertrophic cranial pachymeningitis associated with middle ear inflammation. Otol Neurotol 2006;27:928–33CrossRefGoogle ScholarPubMed
7 Kanzaki, S, Inoue, Y, Watabe, T, Ogawa, K. Hypertrophic chronic pachymeningitis associated with chronic otitis media and mastoiditis. Auris Nasus Larynx 2004;31:155–9CrossRefGoogle ScholarPubMed
8 Wasser, SP, Weis, AL. Therapeutic effects of substance occurring in higher Basidiomycetes mushrooms: a modern perspective. Crit Rev Immunol 1999;19:65–96Google ScholarPubMed
9 Bart-Delabesse, E, Basile, M, Al Jijakli, A, Souville, D, Gay, F, Philippe, B et al. Detection of aspergillus galactomannan antigenemia to determine biological and clinical implications of beta-lactam treatments. J Clin Microbiol 2005;43:5214–20CrossRefGoogle ScholarPubMed
10 Vlantis, AC, Tsang, RK, Yu, BK, Kam, MK, Tong, MC, Lo, PS et al. Nasopharyngectomy and surgical margin status: a survival analysis. Arch Otolaryngol Head Neck Surg 2007;133:1296–301CrossRefGoogle ScholarPubMed
11 Pak, MW, Chan, KL, van Hasselt, CA. Retropharyngeal abscess. A rare presentation of nasopharyngeal carcinoma. J Laryngol Otol 1999;113:70–2CrossRefGoogle ScholarPubMed