Case Reports. Chronic and acute Aspergillus meningitis

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1: Mycoses. 2002 Dec;45(11-12):504-11. Related Articles, Links

Case Reports. Chronic and acute Aspergillus meningitis.

Moling O, Lass-Floerl C, Verweij PE, Porte M, Boiron P, Prugger M,

Gebert U, Corradini R, Vedovelli C, Rimenti G, Mian P.

Cerebral aspergillosis usually occurs in severely immunocompromized

hosts, is difficult to diagnose, and has a poor prognosis. After 14

months of chronic meningitis, ventriculitis, choroid plexitis, and

lumbar arachnoiditis, which was complicated by acute hydrocephalus,

Aspergillus, suspected to be from the candidus group, was isolated

from the cerebrospinal fluid (CSF) of a previously healthy man.

Thereafter Aspergillus antigen was found in stored plasma and CSF

samples. He was treated with voriconazole and itraconazole. In a

haemodialysis patient affected by an acute meningococcal meningitis,

following a 3-day symptom-free interval, symptoms and signs of acute

meningitis had reappeared and were unresponsive to a broad

antimicrobial coverage. However, they resolved within 5 days after

liposomal amphotericin B treatment had been started. From his CSF

Aspergillus-DNA was identified and Aspergillus fumigatus isolated by

culture. These two different clinical cases show that Aspergillus-

DNA and antigen detection tests represent an advance in the

diagnosis and liposomal amphotericin B, voriconazole, and

itraconazole are an advance in the treatment of Aspergillus

meningitis.

Publication Types:

Case Reports

Letter

PMID: 12472730 [PubMed - indexed for MEDLINE]