Central Nervous System Aspergillosis: Analysis of 26 Patients

B. Boes, R. Bashir, C. Boes, F. Hahn, J. R. McConnell, Rodney D McComb

Research output: Contribution to journalArticle

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Abstract

The clinical presentation, risk factors, laboratory data, and neuroimaging and neuropathological findings in 26 patients with autopsy proved central nervous system (CNS) aspergillosis are reviewed. Eleven patients had hematological malignancies (8 underwent bone marrow transplantation), 8 patients underwent liver transplantation, and 3 patients had acquired immunodeficiency syndrome. Four had illnesses resulting in immunosuppression (systemic lupus erythematosus, infected aortic graft, neuroblastoma, and fulminant hepatic failure). The most common presenting clinical symptoms of CNS aspergillosis were fever and a strokelike syndrome. Risk factors for developing CNS aspergillosis included neutropenia, immunosuppressive therapy, low CD4 counts, and retransplantation. Spinal fluid findings were nondiagnostic. Computed tomograms and magnetic resonance scans of the head showed low-density lesions or hemorrhagic infarctions. Most aspergillosis cases occurred in the setting of widely disseminated disease commonly arising from the lung. Pathologically, multiple areas of necrosis throughout the brain were seen. Aspergillus invasion of blood vessel walls was seen microscopically. Amphotericin B with or without flucytosine was not effective treatment.

Original languageEnglish (US)
Pages (from-to)123-129
Number of pages7
JournalJournal of Neuroimaging
Volume4
Issue number3
DOIs
StatePublished - Jan 1 1994

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Aspergillosis
Central Nervous System
Flucytosine
Acute Liver Failure
Amphotericin B
Hematologic Neoplasms
Aspergillus
Immunosuppressive Agents
CD4 Lymphocyte Count
Neutropenia
Bone Marrow Transplantation
Neuroblastoma
Neuroimaging
Systemic Lupus Erythematosus
Liver Transplantation
Immunosuppression
Infarction
Blood Vessels
Autopsy
Acquired Immunodeficiency Syndrome

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

Central Nervous System Aspergillosis : Analysis of 26 Patients. / Boes, B.; Bashir, R.; Boes, C.; Hahn, F.; McConnell, J. R.; McComb, Rodney D.

In: Journal of Neuroimaging, Vol. 4, No. 3, 01.01.1994, p. 123-129.

Research output: Contribution to journalArticle

Boes, B, Bashir, R, Boes, C, Hahn, F, McConnell, JR & McComb, RD 1994, 'Central Nervous System Aspergillosis: Analysis of 26 Patients', Journal of Neuroimaging, vol. 4, no. 3, pp. 123-129. https://doi.org/10.1111/jon199443123
Boes, B. ; Bashir, R. ; Boes, C. ; Hahn, F. ; McConnell, J. R. ; McComb, Rodney D. / Central Nervous System Aspergillosis : Analysis of 26 Patients. In: Journal of Neuroimaging. 1994 ; Vol. 4, No. 3. pp. 123-129.
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