Invasive pulmonary aspergillosis with brain dissemination in an immunocompetent host
DOI:
https://doi.org/10.4322/acr.2021.280Keywords:
Invasive Pulmonary Aspergillosis, Neuroaspergillosis, Autopsy, MicroscopyAbstract
Invasive aspergillosis is an uncommon infection, which is mainly seen among immunocompromised patients. In recent years, cases of aspergillosis involving immunocompetent hosts are increasingly being reported. Herein, we report the case of a 27-year-old man with fever, productive cough, shortness of breath, and left hemiparesis. He had suffered trauma to his head 25 days prior. Imaging of the chest showed bilateral cavitary lesions in the lungs, and neuroimaging revealed a space-occupying lesion in the right frontoparietal cerebrum. He was suspected of having an abscess or metastasis. He died on day 3 of hospitalization, and an autopsy was performed. The autopsy revealed the cause of death to be invasive pulmonary aspergillosis, with brain dissemination. Invasive aspergillosis is uncommon in apparently immunocompetent individuals, and we discuss the autopsy findings in detail.
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El Hasbani G, Chirayil J, Nithisoontorn S, et al. Cerebral aspergillosis presenting as a space occupying lesion in an immunocompetent individual. Med Mycol Case Rep. 2019;25:45-8. http://dx.doi.org/10.1016/j.mmcr.2019.07.011. PMid:31453078.
Jameson JL. Aspergillosis. In: Denning DW, editor. Harrison’s principles of internal medicine. 20th ed. United States of America: McGraw-Hill Education; 2018. p. 1532-37.
Narayan SK, Kumar K, Swaminathan RP, Roopeshkumar VR, Bhavna B. Isolated cerebral aspergilloma in a young immunocompetent patient. Pract Neurol. 2009;9(3):166-8. http://dx.doi.org/10.1136/jnnp.2009.176594. PMid:19448060.
Xu X-Y, Sun H-M, Zhao B-L, Shi Y. Diagnosis of airway-invasive pulmonary aspergillosis by tree-in-bud sign in an immunocompetent patient: case report and literature review. J Mycol Med. 2013;23(1):64-9. http://dx.doi.org/10.1016/j.mycmed.2012.12.050. PMid:23375859.
Kim SH, Kim MY, Hong SI, et al. Invasive pulmonary aspergillosis-mimicking tuberculosis. Clin Infect Dis. 2015;61(1):9-17. http://dx.doi.org/10.1093/cid/civ216. PMid:25778752.
Haydour Q, Hage CA, Carmona EM, et al. Diagnosis of fungal infections. A systematic review and meta-analysis supporting American Thoracic Society Practice Guideline. Ann Am Thorac Soc. 2019;16(9):1179-88. http://dx.doi.org/10.1513/AnnalsATS.201811-766OC. PMid:31219341.
Li W, Shafi N, Periakaruppan R, Valyi-Nagy T, Groth J, Testai FD. Cerebral aspergillosis in a diabetic patient leading to cerebral artery occlusion and ischemic stroke: a case report and literature review. J Stroke Cerebrovasc Dis. 2015;24(1):e39-43. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2014.08.025. PMid:25444026.
Sidani C, Freiser ME, Saigal G, Sklar E. Unusual case of cerebral aspergillosis with clinical and imaging findings mimicking lymphoma. Neuroradiol J. 2013;26(3):290-6. http://dx.doi.org/10.1177/197140091302600306. PMid:23859284.
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