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Aspergillus brain abscess in a patient with normal immunity--case report
N Kawakami1, T Nishizaki, S Sugiyama
1Department of Neurosurgery, Yamaguchi University School of Medicine.
Neurologia Medico-Chirurgica
|April 1, 1994
Summary
This case study highlights a rare Aspergillus brain abscess in an immunocompetent patient. Surgical removal and antifungal therapy led to successful treatment and no recurrence.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Central nervous system aspergillosis is a rare but severe opportunistic infection.
- Brain abscesses due to Aspergillus are particularly uncommon in immunocompetent individuals.
Observation:
- A 53-year-old immunocompetent male presented with frontal headache, found to have a left frontal lobe lesion on MRI.
- T2-weighted MRI showed a hypointense lesion characteristic of aspergillosis, extending into the right frontal lobe and ethmoid sinus.
- Surgical exploration revealed an elastic-hard mass with a central cavity, consistent with an Aspergillus abscess.
Findings:
- Histological examination confirmed the diagnosis of Aspergillus abscess.
- The abscess was surgically removed with near-total excision.
- Postoperative treatment included amphotericin B and fluconazole for 2 months.
Implications:
- This case underscores the importance of considering fungal infections, even in immunocompetent hosts.
- Early diagnosis and aggressive management, including surgical debridement and antifungal therapy, are crucial for favorable outcomes.
- The characteristic T2-hypointense appearance on MRI may aid in the diagnosis of Aspergillus brain abscess.