Aspergillose cérébrale chez le sujet immunocompétent. À propos de trois cas

A Case of Cerebral Aspergillosis in a Patient with Chronic Lymphoid Leukemia

“…Cerebral aspergillosis can appear following hematogenous dissemination from lung or sinus lesions [7] [8] [9]. Pulmonary aspergillosis results from the inhalation of Aspergillus spores.…”

Neurological Involvement Complicating Invasive Pulmonary Aspergillosis

“…Two forms of manifestation depending on the immune status are to be distinguished in imaging, it can be an abscess with peripheral contrast surrounded by a perilesional oedema in patients with little or no immunosuppression, secondary to sinus aspergillosis or lesions of the white matter, basal ganglia or thalamus which are enhanced after injection and occur by hematogenous dissemination in patients with profound immunosuppression, as in the case of our patient. 3 …”

“…2 Two forms of manifestation depending on the immune status are to be distinguished in imaging, it can be an abscess with peripheral contrast surrounded by a perilesional oedema in patients with little or no immunosuppression, secondary to sinus aspergillosis or lesions of the white matter, basal ganglia or thalamus which are enhanced after injection and occur by hematogenous dissemination in patients with profound immunosuppression, as in the case of our patient. 3 Cerebral MRI allows a better characterization of these lesions, it finds multiple cortico-subcortical lesions in T2 hypersignal, in T1 hyposignal, with or without annular enhancement after injection of gadolinium. In MRI diffusion weighted imaging (DWI), these lesions present 3 areas with different signals: central and peripheral hyposignal corresponding respectively to necrosis and vasogenic oedema and a hypersignal of the intermediate area with low ADC related to an infarcted area.…”

Cerebral Aspergillosis in an Immunocompetent Patient after COVID-19 Infection

“…3 The treatment commonly employed involves a combined approach of surgical evacuation and prolonged antifungal administration. 4,[12][13][14] There is no consensus regarding the best surgical strategy, since most studies 2,4,6,7 are small retrospective series. However, the most adopted approach in cases of location in an eloquent area is minimally-invasive aspiration by the stereotaxic method or by neuronavigation.…”

“…1 Aspergillus hyphae have tropism for vessels and can produce thrombosis, infarction, hemorrhagic changes, or mycotic aneurysms. 3,6 Meningeal lesions usually represent contamination by contiguity after infection of the paranasal sinuses, mastoiditis, trauma, or neurosurgery. 2 Parenchymal abscesses are most commonly located in the cerebral hemispheres; however, they may also present in the basal ganglia, corpus callosum, thalamus, or perforating artery territory, suggesting hematogenous dissemination.…”