Aspergillus terreus brain abscess mimicking tumor progression in a patient with treated glioblastoma multiforme

Clinical Neuropathology
D M DamekB K Kleinschmidt-DeMasters

Abstract

To detail a case of Aspergillus terreus brain abscess in a patient undergoing treatment for malignant glioma. Central nervous system aspergillosis usually occurs in patients with hematopoietic neoplasms or post transplantation, not in those with solid tumors. Most systemic invasive mold infections are attributable to Aspergillus fumigatus or Aspergillus flavus. The patient had received external beam radiation, temozolomide chemotherapy, and high-dose steroids, and had lymphopenia, but not sustained neutropenia. She developed a brain mass that mimicked tumor progression by neuroimaging criteria; infection was not a consideration. Brain biopsy showed fungal cerebritis and cultures grew A. terreus, a variant being reported with greater frequency as a pathogen in patients with risk factors for aspergillosis. Brain tumor patients who receive steroids to control their peritumoral edema may be particularly susceptible to cerebral A. terreus infection, especially when they additionally develop the lymphopenia commonly associated with temozolomide.

Citations

Feb 16, 2012·Medical Mycology·Sophia KooFrancisco M Marty
Jun 6, 2016·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·M GautierS Ranque
Jun 14, 2012·Advances in Anatomic Pathology·Marie Rivera-Zengotita, Anthony T Yachnis

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