An unexpected intracerebral lesion - case report of a superinfected aspergillosis mimicking a brain metastasis.

BMC Infectious Diseases
Basil Erwin GrüterMarkus Florian Oertel

Abstract

Invasive aspergillosis of the central nervous system is a rare but increasingly prevalent disease. We present the unusual case of an immunosuppressed patient suffering from unexpected superinfected invasive aspergillosis with cerebral, pulmonal, and adrenal manifestations, mimicking a metastasized bronchial carcinoma. This report reveals the importance of including aspergillosis in the differential diagnosis of a cerebral mass lesion in the light of unspecific clinical findings. A 58-year-old immunocompromised female presented to our emergency department with a single tonic-clonic seizure. Imaging showed a ring enhancing cerebral mass with perifocal edema and evidence of two smaller additional hemorrhagic cerebral lesions. In the setting of a mass lesion in the lung, and additional nodular lesions in the left adrenal gland the diagnosis of a metastasized bronchus carcinoma was suspected and the cerebral mass resected. However, histology did not reveal any evidence for a neoplastic lesion but septate hyphae consistent with aspergillus instead and microbiological cultures confirmed concomitant staphylococcal infection. A high index of suspicion for aspergillus infection should be maintained in the setting of immunosuppression. Cl...Continue Reading

References

Mar 29, 2002·Academic Radiology·Kei YamadaYuji Numaguchi
Oct 7, 2005·Journal of Clinical Microbiology·Emmanuelle Bart-DelabesseAnnick Datry
Mar 28, 2009·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Badr M AlmutairiAli H Asseri
Nov 12, 2017·Indian Journal of Pediatrics·Pratibha Singhi, Arushi Gahlot Saini
May 23, 2018·Infection·Katarzyna GóralskaMagdalena Dzikowiec

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