Isolated cerebral aspergillosis without a portal of entry-complete recovery after liposomal amphotericin B and surgical treatment

García, A. Delgado; Mazuecos, Auxiliadora; Clayo, A; Pérez-Requena, J; Mangas, A; Alonso, Francisco A.; Ceballos, Ma Esther Gutiérrez Díaz; Rivero, M J

doi:10.1093/ndt/13.9.2385

Cited by 10 publications

(3 citation statements)

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“…Infarcts or hemorrhagic CNS lesions may also be observed, because of the angiotropic character of Aspergillus with its propensity to cause vascular invasion ( 19). Although successfully treated cases have rarely been documented ( 20, 21), the mortality rate associated with CNS aspergillosis remains virtually 100%.…”

Section: Focal Central Nervous System Infectious Lesionsmentioning

confidence: 99%

Infections of the central nervous system in transplant recipients

Singh

Husain

2000

Transplant Infectious Dis

124

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Central nervous system (CNS) infections, accounting for 4-29% of CNS lesions in transplant recipients, are a significant post-transplant complication. Focal CNS infectious lesions or brain abscesses have been documented in 0.36-1% of the transplant recipients. Mycelial fungi, particularly Aspergillus, are by far the most frequent etiologies of post-transplant brain abscesses. Bacteria, with the exception of Nocardia, are rarely associated with brain abscesses in transplant recipients. Time of onset and concurrent extraneural lesions have implications relevant towards invasive diagnostic procedures in transplant recipients with brain abscesses. Meningoencephalitis in transplant recipients is predominantly due to viruses, e.g., herpesviruses, and less frequently due to Listeria monocytogenes, Toxoplasma gondii, and Cryptococcus. Despite a wide, and at times perplexing array of opportunistic pathogens that can cause CNS infections, the temporal association of the infection with the time elapsed since transplantation, risk factors, clinical manifestations, and neuroimaging characteristics of the lesion can allow a reasoned and rational approach towards the recognition, diagnosis, and appropriate management of CNS infections in transplant recipients.

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Section: Focal Central Nervous System Infectious Lesionsmentioning

confidence: 99%

Infections of the central nervous system in transplant recipients

Singh

Husain

2000

Transplant Infectious Dis

124

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“…Cerebral aspergillosis in immunocompromized patients has a poor prognosis. Single case reports of successful treatment of cerebral aspergillosis have been increasingly reported with liposomal amphotericin B [22–25], itraconazole [4,6,26], and with voriconazole [7,27].…”

Section: Introductionmentioning

confidence: 99%

Case Reports. Chronic and acute Aspergillus meningitis

Moling

Lass-Floerl

Verweij

et al. 2002

Mycoses

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Cerebral aspergillosis usually occurs in severely immunocompromized hosts, is difficult to diagnose, and has a poor prognosis. After 14 months of chronic meningitis, ventriculitis, choroid plexitis, and lumbar arachnoiditis, which was complicated by acute hydrocephalus, Aspergillus, suspected to be from the candidus group, was isolated from the cerebrospinal fluid (CSF) of a previously healthy man. Thereafter Aspergillus antigen was found in stored plasma and CSF samples. He was treated with voriconazole and itraconazole. In a haemodialysis patient affected by an acute meningococcal meningitis, following a 3-day symptom-free interval, symptoms and signs of acute meningitis had reappeared and were unresponsive to a broad antimicrobial coverage. However, they resolved within 5 days after liposomal amphotericin B treatment had been started. From his CSF Aspergillus-DNA was identified and Aspergillus fumigatus isolated by culture. These two different clinical cases show that Aspergillus-DNA and antigen detection tests represent an advance in the diagnosis and liposomal amphotericin B, voriconazole, and itraconazole are an advance in the treatment of Aspergillus meningitis.

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“…Cerebral aspergillosis in immunocompromized patients has a poor prognosis. Single case reports of successful treatment of cerebral aspergillosis have been increasingly reported with liposomal amphotericin B [22][23][24][25], itraconazole [4,6,26], and with voriconazole [7,27].…”

Section: Introductionmentioning

confidence: 99%