Beyond the usual suspects: fungal hypertrophic pachymeningitis with cranial neuropathies
AI Summary
Consider fungal aetiologies in hypertrophic pachymeningitis presenting with multiple cranial neuropathies, especially in immunocompromised or atypical clinical courses.
Diagnosis requires MRI evidence of dural thickening plus dural biopsy with histology, fungal culture and molecular testing for definitive identification.
Early targeted antifungal therapy, surgical drainage when indicated and correction of immunosuppression improve neurological outcomes and reduce relapse risk.
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