Central Nervous System Aspergillosis: An Unexpected Complication following Neurosurgery

Zamora, Jose Armando Gonzales; Henry, Zachary; Gultekin, Sakir H.

doi:10.3390/diseases6020046

Cited by 11 publications

(13 citation statements)

References 18 publications

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“…Aspergillus can reach the brain either from adjacent sinuses or by hematogenous spread, since Aspergillus can be angioinvasive and thus may disseminate in the blood. Immunocompetent patients mount responses against the fungus and these may result in formation of abscess or granulomas 6,7 . In the present case, the patient was nondiabetic and had no primary lung infection, and mounted a granulomatous reaction against the fungus.…”

Section: Discussionmentioning

confidence: 64%

Aspergillus encephalitis masquerading as brain tumor: Diagnosis in a challenging case by intraoperative cytology

Chaurasia

Tandon

Karuna

et al. 2020

Diagnostic Cytopathology

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Section: Discussionmentioning

confidence: 64%

Aspergillus encephalitis masquerading as brain tumor: Diagnosis in a challenging case by intraoperative cytology

Chaurasia

Tandon

Karuna

et al. 2020

Diagnostic Cytopathology

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“…are opportunistic pathogens, typically causing invasive disease in immunocompromised patients, and represent a rare cause of potentially fatal surgical wound infections and abscesses in affected patients [ 2 , 5 , 6 , 8 , 9 ]. Much research has associated the risk of postsurgical aspergillosis with the use of corticosteroids, such as daily prolonged prednisone use [ 2 , 5 , 10 ]. Other cases have reported aspergillosis in the nervous system in immunocompetent hosts postsurgery [ 5 , 6 , 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…There are numerous pathogenic Aspergillus spp. of which A. fumigatus is the most common species isolated postneurosurgery [ 2 , 5 , 11 ]. A. fumigatus is ubiquitous in the environment and commonly transmitted through conidial inhalation.…”

Section: Discussionmentioning

confidence: 99%

Aspergillus fumigatus Epidural Abscess and Postsurgical Wound Infection in an Immunocompetent Host

Montreuil,

Martinez,

Budrie

et al. 2024

Case Reports in Infectious Diseases

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In this case, we present an immunocompetent patient who had a wound infection secondary to Aspergillus fumigatus after undergoing a neurosurgical procedure that was complicated by an epidural abscess. The patient was treated with voriconazole and responded favorably. We highlight the need for awareness of the possibility of an Aspergillus infection in people without any obvious immunocompromise and advocate for the inclusion of this opportunistic fungus in the workup of postneurosurgical infections and dura-based collections. A brief review of relevant literature is also included.

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“…Aspergillosis can currently be detected using next-generation sequencing, which provides a more convenient approach for the early diagnosis of CNS aspergillosis. [ 17 , 20 – 22 ]…”

Section: Discussionmentioning

confidence: 99%

Central nervous system aspergillosis in immunocompetent patients

et al. 2020

Medicine

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The aim of this study was to investigate the clinical characteristics of central nervous system (CNS) aspergillosis in immunocompetent patients. This study enrolled six immunocompetent patients diagnosed with CNS aspergillosis. Additionally, we reviewed the clinical profiles for 28 cases reported in the literature. The age, gender, etiology of Aspergillus infection, clinical manifestations, location of the lesion, treatment, and prognosis were analyzed. There were 19 men (average age, 54.6 ± 14.3 years) and 15 women (average age, 47.0 ± 19.4 years). The clinical manifestations included headache (55.9%; n = 19), visual impairment (32.4%; n = 11), diplopia (32.4%; n = 11), hemiplegia (20.6%; n = 7), fever (17.6%; n = 6), and epilepsy (8.8%; n = 3). According to the radiological features, CNS aspergillosis lesions were divided into two subtypes: parenchymal lesions in the cerebral lobes (n = 11), and meningeal lesions in the meninges (n = 23). The patients with meningeal lesions are easy to be complicated with more serious cerebrovascular diseases, such as subarachnoid hemorrhage and massive infarction. Most of the lesions in brain parenchyma were abscess formation, and magnetic resonance imaging showed ring enhancement. The clinical diagnosis of Aspergillus infection was mainly based on brain biopsy (n = 14), autopsy (n = 8), pathological examination of adjacent brain tissues (n = 7), cerebrospinal fluid (CSF) or tissue culture (n = 3), and second-generation sequencing analysis of the CSF (n = 3). Clinical improvement was achieved in 23 cases, and 11 patients succumbed to the disease. Voriconazole treatment was effective in 24 (70.6%) cases. Immunocompetent subjects are also at risk for Aspergillus infections. Concomitant cerebrovascular diseases are common in patients with CNS aspergillosis, especially in patients with meningeal aspergillosis. Parenchymal aspergillosis lesions are usually localized and manifest as brain abscesses with annular enhancement on magnetic resonance imaging. Biopsy, CSF culture, and next-generation sequencing are mainstream diagnostic modalities. Voriconazole is an effective treatment for Aspergillus infection, and early diagnosis and treatment should be highlighted.

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Central Nervous System Aspergillosis: An Unexpected Complication following Neurosurgery

Cited by 11 publications

References 18 publications

Aspergillus encephalitis masquerading as brain tumor: Diagnosis in a challenging case by intraoperative cytology

Aspergillus encephalitis masquerading as brain tumor: Diagnosis in a challenging case by intraoperative cytology

Aspergillus fumigatus Epidural Abscess and Postsurgical Wound Infection in an Immunocompetent Host

Central nervous system aspergillosis in immunocompetent patients

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