Related Experiment Video
Updated: Mar 24, 2026
Infection of Zebrafish Larvae with Aspergillus Spores for Analysis of Host-Pathogen Interactions
Published on: May 16, 2020
Multiple Brain Abscesses Due to Aspergillus Fumigatus in a Patient With Liver Cirrhosis: A Case Report
Hung-Jen Tang1, Wei-Lun Liu, Tsung Chain Chang
1From the Department of Medicine (H-JT), Chi Mei Medical Center, Tainan, and Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan; Department of Intensive Care Medicine (WWL, CCL), Chi Mei Medical Center, Liouying, Tainan; Department of Medical Laboratory Science and Biotechnology (TCC), College of Medicine, National Cheng Kung University, Tainan; Department of Internal Medicine (M-CL, W-CK, C-JW), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan; National Institute of Infectious Diseases and Vaccinology (C-JW), National Health Research Institutes, Tainan; Department of Medical Research (Y-CC), Chi Mei Medical Center, Tainan; and Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
Abstract:
Invasive cerebral aspergillosis always developed in immunocompromised host. Early diagnosis may save life in this critical condition; however, it is difficult to reach. Herein, we presented an unusual case of invasive cerebral aspergillosis in a cirrhotic patient. A 47-year-old man presented with progressive deterioration of consciousness for three days. The patient had a history of alcoholic liver cirrhosis, Child-Pugh class C. Magnetic resonance imaging (MRI) of brain showed multi-focal parenchymal lesions, which was consistent with multiple brain abscesses. The diagnosis of invasive cerebral aspergillosis was made by molecular based laboratory methods including Aspergillus galactomannan antigen assay and oligonucleotide array. Despite treatment with the antifungal agent, Amphotericin B, the patient died at the ninth day of hospitalization. Our findings suggest that liver cirrhosis can be one of risk factors of invasive cerebral aspergillosis, and support the diagnosing usefulness of MRI, Aspergillus galactomannan antigen assay, and oligonucleotide array.
Insights
Invasive cerebral aspergillosis is a rare but critical fungal infection. This case highlights liver cirrhosis as a potential risk factor and emphasizes advanced diagnostics for early detection.
Area of Science:
- Mycology
- Neurology
- Infectious Diseases
Background:
- Invasive cerebral aspergillosis is a severe opportunistic infection primarily affecting immunocompromised individuals.
- Early diagnosis is crucial for patient survival but remains diagnostically challenging.
- Liver cirrhosis, particularly Child-Pugh class C, represents a less recognized risk factor for invasive fungal infections.
Observation:
- A 47-year-old male with alcoholic liver cirrhosis presented with rapid neurological decline.
- Brain Magnetic Resonance Imaging (MRI) revealed multifocal lesions suggestive of brain abscesses.
- Diagnostic confirmation was achieved through molecular methods: Aspergillus galactomannan antigen assay and oligonucleotide array.
Findings:
- The patient was diagnosed with invasive cerebral aspergillosis, a rare complication in cirrhotic patients.
- Despite prompt initiation of antifungal therapy with Amphotericin B, the patient's outcome was fatal.
- Advanced imaging and molecular diagnostics proved essential for identifying the fungal infection.
Implications:
- This case underscores liver cirrhosis as a significant risk factor for invasive cerebral aspergillosis.
- It highlights the diagnostic utility of MRI, Aspergillus galactomannan antigen assay, and oligonucleotide array in complex cases.
- Further research is warranted to elucidate the mechanisms linking cirrhosis and invasive fungal infections of the brain.
