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Case Reports. Chronic and acute Aspergillus meningitis.
Mycoses
|December 11, 2002
Summary
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.