Medical Mycology Journal
Online ISSN : 2186-165X
Print ISSN : 2185-6486
ISSN-L : 2185-6486
Short Report
Angio-invasive Cerebral Aspergillosis Resulting in Hemispheric Infarct in an Immunocompetent Man
Nishant GoyalHimanshu NarulaJitender ChaturvediSanjay AgrawalChinmaya DashSuneeta MeenaNeelam Kaistha
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2020 Volume 61 Issue 3 Pages 49-53

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Abstract

Background: Cerebral aspergillosis usually affects immunocompromised hosts and may rarely occur in immunocompetent individuals. Due to its angio-invasive nature, Aspergillus may cause various vascular complications, particularly mycotic aneurysms and infarcts. Case presentation: A 22-year-old immunocompetent male with diagnosed case of sino-cerebral aspergillosis was taking voriconazole for two months. His headache worsened and repeat imaging showed an increase in the size of the lesion. The patient was managed with right frontal craniotomy and surgical debridement, and voriconazole was continued. After ten days of uneventful post-operative course, the patient developed left-sided hemispheric infarct. The patient is doing well at nine months' follow-up, and he is off voriconazole for three months after the follow-up imaging showed complete resolution of disease. Conclusion: Treatment of choice for cerebral aspergillosis is voriconazole. Surgical debridement may be a useful adjunct in patients not responding to voriconazole alone.

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© 2020 The Japanese Society for Medical Mycology
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