脳内出血を合併したアスペルギルス症の2例

Two Cases of Cerebral Aspergillosis with Intracerebral Hemorrhage

I．はじめに

　近年，抗生剤，ステロイド剤の大量使用，悪性腫瘍に対する化学療法，さらに臓器移植などに対する免疫抑制剤の投与により，真菌による感染症が増加傾向にある．特にアスペルギルス症は注目を浴びてきているが，アスペルギルス症の増加に伴い頭蓋内アスペルギルス症も増加傾向を示している^5,8）．本症はその病態が多彩であり，診断，治療とも非常に困難で，予後は一般に不良である．今回われわれは脳内出血をきたした脳アスペルギルス症の2例を経験した．これらの症例のような巨大血腫合併の報告は稀であり，文献的考察を加えて報告する．

Two patients who had cerebral aspergillosis with massive intracerebral hemorrhage were presented. Casee I was a 59-year-old woman who had slight men-tal retardation. There was swelling in the left forehead, from which mucosal cysts of frontal sinus had been re-moved 2 years before her admission. She had a dia-gnosis of subdural abscess and radical operation was performed. Aspergillus was found in the abscess histo-logically. Three months after the operation, CT scan re-vealed multiple abscess in bilateral frontal lobe.