Brain abscess with concurrent infection: tuberculosis and aspergillosis

Area of Science:

• Neurology
• Infectious Diseases
• Mycology

Background:

• Brain abscesses are typically caused by a single pathogen.
• Coinfections with multiple pathogens are rare but present diagnostic challenges.

Purpose of the Study:

• To report a rare case of brain abscess coinfection.
• To emphasize the importance of tissue diagnosis in managing complex infections.

Main Methods:

• Clinical presentation of a middle-aged immunocompetent woman with focal motor seizures.
• Brain imaging revealing a frontal ring-enhancing lesion.
• Excision biopsy for definitive pathogen identification.

Main Results:

• Coinfection with Mycobacterium tuberculosis and Aspergillus spp. was identified.
• The patient initially treated with antitubercular therapy and corticosteroids showed improvement.
• Worsening symptoms upon corticosteroid tapering necessitated further investigation and led to diagnosis.

Conclusions:

• Coinfections in brain abscesses require accurate tissue diagnosis for targeted therapy.
• Combined antitubercular and antifungal treatment resulted in a favorable outcome.
• This case underscores the need for considering multiple pathogens in refractory or atypical brain infections.