Multiple Aspergillus Cerebellar Abscesses in a Middle-Aged Female: Case Report and Literature Review

Abstract

Aspergillus abscesses in the cerebellum are extremely rare, and most cases are solitary. Here, we report the first case of multiple Aspergillus cerebellar abscesses in a 46-year-old female after one mastoidectomy, two craniectomies, and extended use of antibiotics. The possible pathogenesis of this unusual event is discussed. Good outcome was achieved by treatment with a combination of neurosurgical resection and voriconazole (VRC) administration, which we suggest is a potential management plan.

Aspergillus flavus -Induced Brain Abscess in an Immunocompetent Child: Case report

“…Antifungal therapy alone reportedly has a poor outcome for patients with CNS aspergillosis, with a high mortality rate of >90%; this is likely due to the poor penetration of the CNS by the antifungal drugs. 2 Other research has indicated that surgical resection of focal CNS aspergillosis lesions reduces the mortality rate from 64% to 39%. 2 Overall, voriconazole seems to be the drug of choice for the treatment of aspergillosis.…”

“…2 Other research has indicated that surgical resection of focal CNS aspergillosis lesions reduces the mortality rate from 64% to 39%. 2 Overall, voriconazole seems to be the drug of choice for the treatment of aspergillosis. 2 In the current case, the patient showed clinical and radiological improvement with intravenous voriconazole administration and surgical resection.…”

“…2 Overall, voriconazole seems to be the drug of choice for the treatment of aspergillosis. 2 In the current case, the patient showed clinical and radiological improvement with intravenous voriconazole administration and surgical resection. However, imaging scans at a six-week follow-up revealed that the lesion had progressed despite the continued administration of oral voriconazole; this is unusual due to the high bioavailability level (82.6%) of oral voriconazole.…”

“…2 The brain is remarkably resistant to fungal infections due to its abundant blood supply and the relatively impermeable blood-brain barrier. Nevertheless, despite the existence of anatomical and functional barriers which protect the brain and subarachnoid space, fungal pathogens can breach these barriers under certain conditions.…”

Evolution of CD4+CD25hi T cell subsets in Aspergillus-infected liver transplantation recipients reduces the incidence of transplantation rejection via upregulating the production of anti-inflammatory cytokines

“…Of the nearly 185 Aspergillus species, A. fumigatus is the most prevalent pathogen, and accounts for more than 90% of all infections reported (Chen et al, 2011). The incidence of invasive aspergillosis occurs in 1 to 8% of liver transplant recipients and the mortality rate ranges from 60 to 80% (Fortún et al, 2002;Singh and Paterson, 2005).…”