Aspergillosis of the central nervous system

Golin, Valdir; Sprovieri, Sandra Regina Schwarzwälder; Cançado, José Eduardo Delfini; Daniel, Jefferson Walter; Mimica, Lycia Maria Jenné

doi:10.1590/s1516-31801996000500007

Cited by 12 publications

(12 citation statements)

References 3 publications

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“…Mortality is high in patients with intracranial mycotic infections, especially those with severe immunodeficiency. Only a few are reported who survived after combined medical and surgical treatment of cerebral aspergillosis abscesses [24,25,26]. Successful outcome depends on the following factors: there must be a solitary lesion, it must be a well-demarcated abscess, its location must be favorable, and the patient's condition must be good [27].…”

Section: Discussionmentioning

confidence: 99%

Cerebral aspergillosis: comparison of radiological and neuropathologic findings in patients with bone marrow transplantation

et al. 2001

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Thirty-six lesions in six patients who died from cerebral Aspergillus infection after bone marrow transplantation (BMT) were studied with regard to signal intensity, contrast enhancement, size, and location. The diagnosis was confirmed in all cases by autopsy. Retrospective correlation of histopathological and radiological findings was possible for 14 lesions. Most of the lesions (22/36) had isointense to low signal intensity on T2-weighted images (T2WI). Histopathologically, hemorrhagic necrosis was determined in three of them. Areas of high signal intensity on T1-weighted images (T1WI) were related to gross hemorrhage. Two infarctions showed intravascular accumulation of fungal hyphae with secondary thrombosis of the vessel. The remaining 12 lesions had high signal intensity on T2WI and low on T1WI. Histopathologically, four were infectious and four were unspecific demyelinated lesions. In conclusion, cerebral aspergillosis typically presented with large lesions showing isointense to low signal intensity on T2WI that could have areas of high signal on T1WI. Contrast enhancement was only visible in 15 lesions, and the predominant locations were the subcortical white matter, the cerebellum, and the basal ganglia. Small lesions with high signal on T2WI and low signal on T1WI could not necessarily be related to Aspergillus infection.

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Section: Discussionmentioning

confidence: 99%

Cerebral aspergillosis: comparison of radiological and neuropathologic findings in patients with bone marrow transplantation

et al. 2001

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“…If a possible abnormality is present on chest radiograph, proceeding rapidly to a CT scan may help to guide the decision regarding whether to pursue further invasive testing. Pulmonary aspergillosis is sometimes accompanied by intracerebral disease, a feared complication, which may present with focal neurologic signs, seizures, or lethargy (46–48).…”

Section: Clinical Presentation Of Aspergillosismentioning

confidence: 99%

Aspergillosis in lung transplantation: incidence, risk factors, and prophylactic strategies

Gordon

Avery

2001

Transplant Infectious Dis

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Invasive aspergillosis remains a significant cause of morbidity and mortality in transplantation, especially lung and allogeneic bone marrow transplant recipients. The epidemiology, classic and newly recognized risk factors, and incidence of aspergillosis are reviewed. Risk factors include environmental exposures, airway colonization, profound immunosuppression, neutropenia, prior cytomegalovirus infection, and renal dysfunction. Clinical and radiographic presentations of invasive aspergillosis are discussed, including some unusual manifestations in lung transplant recipients. Early and accurate diagnosis of aspergillosis remains a challenge, and diagnostic strategies are reviewed, with an emphasis on the chest computerized tomography scan and on transbronchial or open lung biopsy. Recent advances include prophylactic and pre-emptive antifungal strategies, newer therapeutic agents, and improved risk stratification.

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“…In invasive aspergillosis, the fungus travels to other organs including the brain, kidney, eye, heart, and skin. Intracerebral aspergillosis can develop through hematogenous spread from the lungs, 9 direct extension from the paranasal sinuses and orbits, 5 or a traumatic event 1 . Intracerebral aspergillosis is more common in immunocompromised patients, but cases have been reported in the immunocompetent host 1–3 .…”

Section: Discussionmentioning

confidence: 99%

Differentiating Intracranial Aspergillosis from a High Grade Glioma Using MRI and MR Spectroscopic Imaging

Pollack

Bhaya

Law

2007

Journal of Neuroimaging

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We compare the MRI (magnetic resonance imaging) and MRSI (MR spectroscopic imaging) findings in a patient with intracerebral aspergillosis to those typically seen in an infiltrating high-grade glioma (HGG). We demonstrate paramagnetic areas of T2-hypointensity due to the pathologic deposition of iron and other paramagnetic elements seen in intracerebral aspergillosis. We also demonstrate the diffusion-weighted imaging (DWI) findings and discuss how MR spectroscopy can be useful in differentiating an aspergilloma from a high-grade glioma.

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Aspergillosis of the central nervous system

Cited by 12 publications

References 3 publications

Cerebral aspergillosis: comparison of radiological and neuropathologic findings in patients with bone marrow transplantation

Cerebral aspergillosis: comparison of radiological and neuropathologic findings in patients with bone marrow transplantation

Aspergillosis in lung transplantation: incidence, risk factors, and prophylactic strategies

Differentiating Intracranial Aspergillosis from a High Grade Glioma Using MRI and MR Spectroscopic Imaging

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