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[A case of Aspergillus brain abscess presenting angular gyrus syndrome]
Yoshifumi Imazu1, Takekazu Ohi, Shougo Yazawa
1Division of Neurology, Department of Internal Medicine, Miyazaki University School of Medicine, Miyazaki-gun, Japan.
Abstract:
A 45-year-old man had been treated for chronic alcoholism and he had fever in September 2000. He was diagnosed as lung aspergillosis from chest X-ray findings, leukocytosis, elevated CRP, and beta-D-glucan. Administration of fluconazole was started and his lung lesion subsided. But, generalized clonic tonic convulsion developed and the brain abscess in the left parietal lobe was found by CT. Therefore we made the diagnosis of brain abscess followed by lung aspergillosis. He also showed angular gyrus syndrome. Its capsule was thick and localized in the left parietal lobe. The patient had the surgical resection in August, 2001. Aspergillus hyphae and infiltration of inflammatory cells were seen in the brain sample, therefore the diagnosis of aspergillosis brain abscess was established. Angular gyrus syndrome was ameliorated after the operation.
Insights
This case study highlights a rare instance of brain abscess caused by Aspergillus following lung aspergillosis in an alcoholic patient. Surgical intervention successfully treated the brain abscess, improving neurological symptoms.
Area of Science:
- Medical Mycology
- Neurology
- Infectious Diseases
Background:
- Chronic alcoholism is a risk factor for opportunistic infections.
- Aspergillosis, a fungal infection, can affect various organs, including the lungs and brain.
- Disseminated fungal infections require prompt diagnosis and treatment.
Observation:
- A 45-year-old male with chronic alcoholism presented with fever and diagnosed lung aspergillosis.
- Treatment for lung aspergillosis led to lesion subsidence but was followed by generalized seizures.
- CT scan revealed a left parietal lobe brain abscess with a thick capsule.
Findings:
- The patient was diagnosed with a brain abscess secondary to lung aspergillosis.
- Histopathological examination of the resected brain tissue confirmed Aspergillus hyphae and inflammatory cell infiltration.
- The patient exhibited angular gyrus syndrome, which resolved post-surgery.
Implications:
- This case underscores the potential for Aspergillus to cause brain abscesses, particularly in immunocompromised individuals.
- Early diagnosis and aggressive management, including surgical resection, are crucial for favorable outcomes in cerebral aspergillosis.
- The successful treatment highlights the importance of considering fungal infections in patients with unexplained neurological deficits.
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