J Korean Neurol Assoc.  1998 Feb;16(1):87-90.

A Case of Intracerebral Aspergillus Abscess Presenting as Cerebral Infarction

• Kim SS
• Jeong JI
• Cha JK
• Kim SH
• Kim JW
• Kim HD

Abstract

BACKGROUND AND SIGNIFICANCE: Fungal infection of the central nervous system can be attributable to Cryptococcus, Nocardia, Mucor, Candida, and rarely Aspergillus. The types of nervous system involvement by Aspergillus can be divided into 4 groups : meningitis, meningoencephalitis, brain abscess, and single solid granuloma. Aspergillosis involving the central nervous system is a rare disease. Aspergillosis presenting as cerebral infarction has been rarely reported. We experienced one case of intracerebral abscess caused by Aspergillus, presenting as cerebral infarction. CASE: A 54-year-old male, with a history of diabetes mellitus for 7 years, was admitted with headache for 1 month. Initial CSF findings showed pleocytosis(180/ul), and increased protein(79mg/dl). On the 2nd admission day, the patient showed left hemiparesis, left facial palsy of central type and drowsiness. Brain MRI revealed right MCA infarction. Neurologic status was stationary for almost 2wks. The WBC count of CSF was increased to 1150/ul on the 14th admission day, and antituberculous medication was started. On the 27th admission day, deep drowsy mentality was noted. Treatment with steroid was done and then mentality was improved to drowsiness. Brain abscess was found in right frontotemporal area and there were herniation signs on the 29th admssion day. Aspiration was done. Aspergillus fumigatus was grown on fungus culture of CSF and amphotericin B was started.
CONCLUSION
We report a rare case of intracerebral Aspergillosis, manifested by right MCA infarction and brain abscess.

MeSH Terms

Abscess*
Amphotericin B
Aspergillosis
Aspergillus fumigatus
Aspergillus*
Brain
Brain Abscess
Candida
Central Nervous System
Cerebral Infarction*
Cryptococcus
Diabetes Mellitus
Facial Paralysis
Fungi
Granuloma
Headache
Humans
Infarction, Middle Cerebral Artery
Magnetic Resonance Imaging
Male
Meningitis
Meningoencephalitis
Middle Aged
Mucor
Nervous System
Nocardia
Paresis
Rare Diseases
Sleep Stages
Amphotericin B