Aspergillosis of Central Nervous System

You, Seung Hoon; Lee, Jung Il; Nam, Do Hyun; Kim, Jong Soo; Hong, Seung Chyul; Shin, Hyung Jin; Park, Kwan; Eoh, Whan; Kim, Jong Hyun

Abstract

OBJECTIVES
Aspergillosis of central nervous system(CNS) is a rare pathologic condition and it has been known to be difficult to diagnose and treat. We analyzed seven cases of central nervous system aspergillosis. The clinical characteristics, and the problems in diagnosis and treatment are discussed with review of previous literatures.
MATERIALS AND METHODS
We reviewed the clinical records, radiological findings, and pathologic reports of 7 patients with aspergillosis which involved CNS.
RESULTS
Five patients were immunocompetent, and infection was related with previous operation in 4 of them. Two patients were immunocompromised and had no history of operation. Five patients had intracranial lesions and two had spinal lesions. Mean duration from the onset of initial symptom to pathologic diagnosis was 2.4 months. Mean duration from the previous operation to the onset of symptom was 9.3 months, and from the onset of symptom to diagnosis was 2.9 months in the patients who had histories of operation. All of them were treated with surgical procedures and intravenous and oral antifungal agents, resulting in cure in 6 cases. Mean duration of the treatment was 4.9 months.
CONCLUSION
Because aspergillosis of CNS is a rare disease and is difficult to be differentiated from the pyogenic abscess or recurrent tumor, the pathologic diagnosis is very important for adequate treatment. Although the prognosis of aspergillosis of CNS has been known to be poor, adequate surgery for both diagnosis and treatment and antifungal chemotherapy resulted in good outcome.