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Acute Stroke as First Manifestation of Cerebral Aspergillosis

Carla Anciones1, Alicia de Felipe1, Asier de Albóniga-Chindurza1

  • 1Neurology Department, Hospital Ramón y Cajal, Madrid, Spain.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|September 3, 2018
PubMed
Abstract

Insights

Acute stroke may be the initial sign of invasive aspergillosis in immunocompromised patients. This fungal infection presented as stroke in all cases, leading to a 100% mortality rate despite treatment.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Mycology

Background:

  • Invasive aspergillosis is a serious fungal infection.
  • Neurological manifestations can be diverse.
  • Fungal brain infections may mimic cerebrovascular events.

Purpose of the Study:

  • To detail neurological signs of invasive aspergillosis.
  • To highlight presentation as acute stroke.
  • To assess outcomes in affected patients.

Main Methods:

  • Retrospective case series (2011-2017).
  • Inclusion criteria: invasive aspergillosis with stroke-like neurological deficits.
  • Data collected: clinical, microbiological, radiological, treatment, and outcomes.

Main Results:

  • Five immunocompromised patients (mean age 55.4) studied.
  • All presented with acute focal neurological deficits mimicking stroke.
  • Galactomannan antigen positive in all; 100% mortality despite antifungal therapy.

Conclusions:

  • Acute stroke can be the primary presentation of invasive aspergillosis.
  • High index of suspicion is needed in immunocompromised individuals with neurological deficits.
  • This presentation is associated with poor prognosis.
Keywords:
Neuroaspergillosisacute strokeantifungal therapyinvasive aspergillosis

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