Cerebral Aspergillosis

緒言

　内外に於けるCerebral Aspergillosisの報告例は予想外に尠く，文献渉猟により，欧米にてはOppe^20）Wätjen^24）等の報告以来僅に27例，本邦にては美甘・佐藤^17），笹本^22）等の数例を数えるに過ぎず。察するに欧米にてはCandida,Crypto-coccus等は比較的普遍的なるに拘らず，Asper-gillus感染は稍々尠く，この間の事情はKeye　＆　Magee^12）に依りSt．LouisのGeneral Hospitalに於ける真菌感染88症例中僅に3例（3.5％）のAspergillus例を挙げたるに過ぎざる事実より窺い得られるが，本邦にてはCandidaに次ぎ検出率高く，我々の検索に於いても過去10年間（1951〜1960）の剖検総数3,091例中に見られた50例の真菌感染症例中Aspergillusは12例（24％）を占めた。而して感染の主座たりし臓器は悉く肺であり，その経過中に血行播種を惹起したるもの4例で，中2例に脳内病変を見出し得たので，之を報告する。

Reviewing literatures, 27 cases of cerebral aspergillosis have been collected. This sho-ws that cerebral involvement by aspergillus is relatively rare in occurrence both in Japan and other foreign countries. Among 3.091 consecutive autopsy cases in our laboratory for the last 10 years (1951-1960), 50 cases were found to have pulmonary involvement by various fungi, aspergillus infection cont-ributing 24% (12 cases). Cerebral involve-ment by this fungus was present in 2 cases, and their clinical and pathological findings were reported in this paper.

Case I. A 37-year-old Japanese male was diagnosed as having pulmonary tuberculosis by an X-ray examination and placed on Streptomycin and INAH. In spite of the therapy, he continued to have cough with spu-tum and left chest pain, which had increased gradually in severity. The total clinical course was about 7 months. In the brain, there were many small hemorrhagic lesions in the subcortical area of the left middle frontal lobe, lingual gyri bilaterally and in the middle lobe of the left cerebellar hemi-sphere.