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Published on: March 9, 2018

Case Reports. Chronic and acute Aspergillus meningitis

O Moling, Cornelia Lass-Floerl, P E Verweij

    Mycoses
    |December 11, 2002
    PubMed

    Insights

    Diagnosing cerebral aspergillosis is challenging, but Aspergillus-DNA and antigen tests offer improved detection. Antifungal treatments like liposomal amphotericin B, voriconazole, and itraconazole show promise for treating this serious fungal infection.

    Area of Science:

    • Infectious Diseases
    • Mycology
    • Neurology

    Background:

    • Cerebral aspergillosis is a rare but severe central nervous system infection.
    • It typically affects immunocompromised individuals and carries a poor prognosis.
    • Diagnosis is often delayed, contributing to poor outcomes.

    Observation:

    • Two distinct cases of Aspergillus meningitis are presented.
    • Case 1: A previously healthy man with chronic meningitis, ventriculitis, and arachnoiditis.
    • Case 2: A hemodialysis patient with relapsed bacterial meningitis.

    Findings:

    • Aspergillus was isolated from CSF in both patients.
    • Aspergillus antigen was detected in plasma and CSF.
    • Aspergillus-DNA was identified in CSF, and Aspergillus fumigatus was cultured.
    • Treatment with voriconazole, itraconazole, and liposomal amphotericin B led to resolution.

    Implications:

    • Aspergillus-DNA and antigen detection represent advancements in diagnosing invasive aspergillosis.
    • Liposomal amphotericin B, voriconazole, and itraconazole are effective treatment options.
    • Early diagnosis and targeted antifungal therapy are crucial for improving outcomes in cerebral aspergillosis.

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