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[Multiple Aspergillus brain abscesses complicated by bronchial asthma].

N Katayama1, H Miyazaki, M Fujimura

  • 1Department of Internal Medicine, Takaoka Municipal Hospital, Toyama, Japan.

Nihon Kokyuki Gakkai Zasshi = the Journal of the Japanese Respiratory Society
|March 21, 2000
PubMed
Summary

A severe asthma attack led to a rare fungal brain infection. Autopsy revealed multiple Aspergillus abscesses, highlighting a critical complication of intensive steroid therapy.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Mycology

Background:

  • Severe asthma exacerbations often require intensive treatment, including mechanical ventilation and high-dose corticosteroids.
  • Immunosuppression secondary to treatment can predispose patients to opportunistic infections.

Observation:

  • A 35-year-old male patient with severe asthma developed neurological deficits after mechanical ventilation withdrawal.
  • Brain imaging revealed multiple lesions consistent with infarcts and hemorrhage.
  • Autopsy confirmed multiple brain abscesses.

Findings:

  • Histological examination of the brain abscesses revealed fungal hyphae consistent with Aspergillus species.
  • Fungal elements were observed within the abscess walls and invading arterial walls, suggesting angioinvasion and embolic spread.

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  • The final diagnosis was multiple Aspergillus infarct abscesses of the brain.

    • Implications:

    • This case underscores the potential for invasive fungal infections, such as Aspergillus brain abscesses, in immunocompromised patients.
    • Early recognition and prompt treatment of invasive fungal sinusitis are crucial to prevent central nervous system dissemination.
    • Clinicians should maintain a high index of suspicion for opportunistic infections in patients receiving prolonged immunosuppressive therapy.