Cerebral Vasculitis Caused by Aspergillus Simulating Ischemic Stroke in an Immunocompetent Patient

Cough and confusion in an elderly man with chronic lymphocytic leukemia

“…The fact that aspergillosis causes an infectious vasculopathy leading to infarcts and hemorrhage in a random distribution, helps to distinguish it from other opportunistic infections like candidiasis, toxoplasmosis and cryptococcosis [3]. Since central nervous system (CNS) aspergillosis has also been described in immunocompetent patients, the differential from primary CNS vasculitis can be challenging [4]. Occasionally, the correct diagnosis can only be achieved through a brain biopsy [5].…”

Invasive filamentous fungus infection with secondary cerebral vasculitis in a patient with no obvious immune suppression

“…We emphasize that our patient did not present any of the comorbid conditions recently reviewed. [2][3][4][5] This group of 'unsuspected' patients is accumulating and may easily be missed. Culture combined with evidence of tissue invasion on histology, or culture of adequate tissue specimens, provides the most certain evidence of IMD.…”

Septic Cavernous Sinus Thrombosis Complicated by Occlusion of the Internal Carotid Artery and Multiple Embolic Strokes After Surgery of an Anorectal Abscess

“…In the first few days the thrombus shows a cortex-isointense signal on native T1weighted 14 and a hypointense signal on T2-weighted images that later changes to high signal in both native T1-weighted and T2-weighted images. [15][16][17]6,18,19 and occlusion 20,21 of the intracavernous segment is reliably visualized in MRI. Contrary to our case, ICA arteritis is commonly nonspecific or primarily observed with invasive mycotic infections from paranasal sinuses.…”