ABSTRACT
We present an uncommon case of isolated basal ganglia mucormycosis in a patient without any known cause of immunosuppression, but with a history of drug injection. The patient presented a good clinical and radiological response to antifungal treatment without aggressive surgical debridement (liposomal amphotericin B combined with isavuconazole for 4 weeks followed by isavuconazole as maintenance therapy for 10 months).
Subject(s)
Central Nervous System Fungal Infections/etiology , Mucormycosis/etiology , Substance Abuse, Intravenous/complications , Substance Abuse, Intravenous/microbiology , Amphotericin B/administration & dosage , Central Nervous System Fungal Infections/diagnosis , Central Nervous System Fungal Infections/drug therapy , Central Nervous System Fungal Infections/microbiology , Cocaine , Cocaine-Related Disorders/complications , Cocaine-Related Disorders/drug therapy , Cocaine-Related Disorders/microbiology , Drug Therapy, Combination , Drug Users , Humans , Magnetic Resonance Imaging , Male , Marijuana Abuse/complications , Marijuana Abuse/drug therapy , Marijuana Abuse/microbiology , Middle Aged , Mucormycosis/diagnosis , Mucormycosis/drug therapy , Mucormycosis/microbiology , Nitriles/administration & dosage , Pyridines/administration & dosage , Substance Abuse, Intravenous/diagnostic imaging , Substance Abuse, Intravenous/drug therapy , Triazoles/administration & dosageABSTRACT
Previous studies have suggested neural disruption and reorganization in adult marijuana users. However, it remains unclear whether these effects persist in adolescents after 28 days of abstinence and, if they do, what Performance x Brain Response interactions occur. Adolescent marijuana users (n=17) and controls (n=17) aged 16-18 years were recruited from local schools. Functional magnetic resonance imaging data were collected after 28 days' monitored abstinence as participants performed a spatial working memory task. Marijuana users show Performance x Brain Response interactions in the bilateral temporal lobes, left anterior cingulate, left parahippocampal gyrus, and right thalamus (clusters >/=1358 microl; p<.05), although groups do not differ on behavioral measures of task performance. Marijuana users show differences in brain response to a spatial working memory task despite adequate performance, suggesting a different approach to the task via altered neural pathways.
