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Published on: October 3, 2010
[Intracranial propagation of invasive aspergilloma in an immuncompromised patient]
Márta Simon1, Ildikó Vastagh, György Várallyay
1Semmelweis Egyetem, Neurológiai Klinika, Budapest.
Abstract:
Aspergillus infection of the central nervous system is a rare disease, occasionally seen among immunocompromised patients. The most frequent pathway is hematogenic dissemination. Less known is the direct propagation from the paranasal sinuses, which is usually observed in immunocompetent patients. We report a patient who developed cavernous sinus syndrome due to an invasive intracranial aspergilloma after longlasting chemo- and steroid therapy for chronic lymphoid leukemia and immunhemolytic anemia. The characteristic features seen on radiological images--brain CT and MRI--suggested the possibility of invasive aspergilloma. Postoperative histology defined the diagnosis. Our case review highlights the importance of considering the possibility of an invasive opportunistic infection of the CNS in an immunocompromised patient presenting a new neurological sign.
Insights
Central nervous system Aspergillus infection is rare in immunocompromised individuals. This case highlights invasive aspergilloma presenting as cavernous sinus syndrome, emphasizing opportunistic CNS infections in immunocompromised patients.
Area of Science:
- Neurology
- Infectious Diseases
- Medical Mycology
Background:
- Central nervous system (CNS) Aspergillus infections are uncommon, primarily affecting immunocompromised patients via hematogenic spread.
- Direct spread from paranasal sinuses is less frequent and typically seen in immunocompetent individuals.
Observation:
- A patient undergoing prolonged chemotherapy and steroid therapy for chronic lymphoid leukemia and immunhemolytic anemia developed cavernous sinus syndrome.
- Radiological imaging (CT and MRI) suggested invasive intracranial aspergilloma.
Findings:
- Postoperative histology confirmed invasive intracranial aspergilloma as the cause of cavernous sinus syndrome.
- This case illustrates a rare presentation of opportunistic CNS infection in an immunocompromised host.
Implications:
- Clinicians should consider invasive opportunistic CNS infections, such as aspergilloma, in immunocompromised patients with new neurological deficits.
- Early diagnosis and treatment are crucial for managing invasive fungal CNS infections.
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