A rare case of meningoencephalitis due to Aspergillus fumigatus
Accepted: 14 March 2023
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Cerebral Aspergillosis (CA) is an opportunistic fungal infection that usually affects immunocompromised hosts. A man was admitted for loss of consciousness and aphasia. Computed Tomography (CT) scan showed a left cerebral frontal lesion. Nasal swab showed hyphae of Aspergillus spp.; isavuconazole was started. Lumbar Puncture (LP) tested positive for galactomannan (index 1.9), and Aspergillus fumigatus grew on the Cerebrospinal Fluid (CSF) culture. Unfortunately, a new episode of fever and a general deterioration then ensued up to the death. In immunocompetent patients as well, chronic fungal rhinosinusitis deserves attention due to its potential for rapid evolution to Central Nervous System (CNS) involvement.
Marr KA, Carter RA, Crippa F, et al. Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients. Clin Infect Dis. 2002;34:909-17. DOI: https://doi.org/10.1086/339202
Wauters J, Baar I, Meersseman P, et al. Invasive pulmonary aspergillosis is a frequent complication of critically ill H1N1 patients: a retrospective study. Intensive Care Med. 2012;38:1761-8. DOI: https://doi.org/10.1007/s00134-012-2673-2
Thompson GR 3rd, Cornely OA, Pappas PG, et al. Invasive Aspergillosis as an Under-recognized Superinfection in COVID-19. Open Forum Infect Dis. 2020;7:ofaa242. DOI: https://doi.org/10.1093/ofid/ofaa242
Patterson TF, Thompson GR 3rd, Denning DW, et al. Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;63:e1-e60. DOI: https://doi.org/10.1093/cid/ciw326
Ashdown BC, Tien RD, Felsberg GJ. Aspergillosis of the brain and paranasal sinuses in immunocompromised patients: CT and MR imaging findings. AJR Am J Roentgenol. 1994;162:155-9. DOI: https://doi.org/10.2214/ajr.162.1.8273655
Azulay-Abulafia L, Sousa MA, Pussanti A, et al. Invasive aspergillosis in a user of inhaled cocaine: rhinosinusitis with bone and cartilage destruction. Rev Soc Bras Med Trop. 2014;47:533-6. DOI: https://doi.org/10.1590/0037-8682-0086-2014
Pekala KR, Clavenna MJ, Shockley R, et al. Chronic invasive fungal sinusitis associated with intranasal drug use. Laryngoscope. 2015;125:2656-9. DOI: https://doi.org/10.1002/lary.25429
Hersh CM, John S, Subei A, et al. Optic Neuropathy and Stroke Secondary to Invasive Aspergillus in an Immunocompetent Patient. J Neuroophthalmol. 2016;36:404-7. DOI: https://doi.org/10.1097/WNO.0000000000000361
Ma Y, Li W, Ao R, et al. Central nervous system aspergillosis in immunocompetent patients: Case series and literature review. Medicine (Baltimore). 2020;99:e22911. DOI: https://doi.org/10.1097/MD.0000000000022911
Copyright (c) 2023 Cesare Bolla, Tommaso Lupia, Andrea Schimmenti, Alberto Gaviraghi, Serena Penpa, Annalisa Roveta, Francesco Giuseppe De Rosa, Guido Chichino, Antonio Maconi
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.