Angio-invasive Cerebral Aspergillosis Resulting in Hemispheric Infarct in an Immunocompetent Man.
angio-invasive
anti-fungal treatment
cerebral aspergillosis
debridement
hemispheric infarct
immunocompetent
vascular complications
Journal
Medical mycology journal
ISSN: 1882-0476
Titre abrégé: Med Mycol J
Pays: Japan
ID NLM: 101562838
Informations de publication
Date de publication:
2020
2020
Historique:
entrez:
1
9
2020
pubmed:
31
8
2020
medline:
15
9
2020
Statut:
ppublish
Résumé
Cerebral aspergillosis usually affects immunocompromised hosts and may rarely occur in immunocompetent individuals. Due to its angio-invasive nature, Aspergillus may cause various vascular complications, particularly mycotic aneurysms and infarcts. A 22-year-old immunocompetent male with diagnosed case of sino-cerebral aspergillosis was taking voriconazole for two months. His headache worsened and repeat imaging showed an increase in the size of the lesion. The patient was managed with right frontal craniotomy and surgical debridement, and voriconazole was continued. After ten days of uneventful post-operative course, the patient developed left-sided hemispheric infarct. The patient is doing well at nine months' follow-up, and he is off voriconazole for three months after the follow-up imaging showed complete resolution of disease. Treatment of choice for cerebral aspergillosis is voriconazole. Surgical debridement may be a useful adjunct in patients not responding to voriconazole alone.
Sections du résumé
BACKGROUND
BACKGROUND
Cerebral aspergillosis usually affects immunocompromised hosts and may rarely occur in immunocompetent individuals. Due to its angio-invasive nature, Aspergillus may cause various vascular complications, particularly mycotic aneurysms and infarcts.
CASE PRESENTATION
METHODS
A 22-year-old immunocompetent male with diagnosed case of sino-cerebral aspergillosis was taking voriconazole for two months. His headache worsened and repeat imaging showed an increase in the size of the lesion. The patient was managed with right frontal craniotomy and surgical debridement, and voriconazole was continued. After ten days of uneventful post-operative course, the patient developed left-sided hemispheric infarct. The patient is doing well at nine months' follow-up, and he is off voriconazole for three months after the follow-up imaging showed complete resolution of disease.
CONCLUSION
CONCLUSIONS
Treatment of choice for cerebral aspergillosis is voriconazole. Surgical debridement may be a useful adjunct in patients not responding to voriconazole alone.
Identifiants
pubmed: 32863328
doi: 10.3314/mmj.20-00005
doi:
Substances chimiques
Voriconazole
JFU09I87TR
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM