Promising effects of corticosteroid treatment in combination with antifungal agents in a patient with Aspergillus meningitis

Abstract

About 10%-15% of cases of Invasive Aspergillosis (IA) affect the central nervous system (CNS) as neuroaspergillosis. 1 Being immunocompromised is the major risk factor for IA of the CNS with reported mortality rate of approximately 90% (compared with 10%-20% in immunocompetent individuals); and developing a proper medical approach for the treatment of neuroaspergillosis is very challenging because of its poor response to treatment. 2 This could be due to intrinsic or acquired antifungal resistance, which is an emerging problem in current era, and even with current guideline of using new antifungal agents, outcomes of patients with this condition are not promising. 3 Patients with neuroaspergillosis present with a variety of signs and symptoms such as fever, headache, dizziness, seizure, lethargy, altered mental status, gait disorders, visual impairment, and diplopia. 4 One of the main manifestations of previously reported cases of IA involving the CNS is mass lesions seen in infectious meningitis. 5