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A Case of Acute Cerebral Aspergillosis Complicating Influenza A/H1N1pdm 2009

Min Jae Kim1, Min-Kyung Kim, Chang Kyung Kang

  • 1Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.

Infection & Chemotherapy
|November 23, 2013
PubMed

Insights

Invasive aspergillosis, a rare complication of influenza, can affect the brain. This case highlights cerebral aspergillosis in a diabetic patient with influenza A/H1N1pdm 2009, emphasizing early diagnosis for better outcomes.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Mycology

Background:

  • Invasive aspergillosis is a rare but serious complication of influenza infections.
  • Cases of invasive pulmonary aspergillosis have been reported with influenza A/H1N1pdm 2009.
  • Cerebral involvement is an uncommon manifestation of invasive aspergillosis.

Purpose of the Study:

  • To report a rare case of acute cerebral aspergillosis in a patient with influenza A/H1N1pdm 2009.
  • To highlight the potential for invasive aspergillosis to occur in the central nervous system during influenza infection.
  • To emphasize the importance of clinical suspicion and prompt diagnosis in patients with risk factors.

Main Methods:

  • Case report of a 24-year-old male with influenza A/H1N1pdm 2009, uncontrolled diabetes, and methicillin-sensitive Staphylococcus aureus pneumonia.
  • Diagnostic workup included imaging revealing new rim-enhancing brain lesions.
  • Confirmation of Aspergillus fumigatus through pathological and culture analysis.

Main Results:

  • The patient developed multiple new rim-enhancing mass lesions in the brain.
  • Pathology and culture confirmed Aspergillus fumigatus infection.
  • Complete resolution of cerebral aspergillosis was achieved with surgical drainage and 18 weeks of antifungal therapy.

Conclusions:

  • Cerebral aspergillosis can occur in patients with influenza, particularly those with diabetes or in intensive care.
  • Early clinical suspicion is crucial for diagnosing invasive aspergillosis in this context.
  • Prompt diagnosis and treatment are essential for improving patient prognosis.
Keywords:
Brain abscessCentral nervous systemDiabetes mellitusInfluenzaInvasive aspergillosis

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