Cerebellar aspergillosis: case report and literature review

Neurosurgery. 2002 Apr;50(4):874-6; discussion 876-7. doi: 10.1097/00006123-200204000-00036.

Abstract

Objective and importance: An unusual, but not unique, case of cerebellar aspergillosis associated with autologous peripheral blood stem cell transplantation for breast cancer is presented.

Clinical presentation: A 45-year-old woman with breast cancer underwent chemotherapy and radiotherapy as well as autologous peripheral blood stem cell transplantation. She developed a cerebellar aspergillosis abscess that was treated successfully with two surgical resections.

Intervention: After removal of pus and the abscess wall, the patient received local application of amphotericin B (AmB). She received AmB 1 mg/kg/d for 3 months and itraconazole 100 mg/kg/d for 1 year. After 3 months of AmB treatment, magnetic resonance imaging revealed that disease had not recurred.

Conclusion: In cases of central nervous system aspergillosis, to increase the therapeutic efficiency, AmB can also be applied to the abscess cavity. Computed tomographic and contrast-enhanced magnetic resonance imaging scans play an important role in establishing early diagnosis in high-risk, immunocompromised patients.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Amphotericin B / therapeutic use
  • Antifungal Agents / therapeutic use
  • Aspergillosis / etiology*
  • Aspergillosis / therapy*
  • Brain Abscess / drug therapy
  • Brain Abscess / etiology
  • Brain Abscess / surgery
  • Breast Neoplasms / surgery
  • Cerebellar Diseases / etiology*
  • Cerebellar Diseases / therapy*
  • Drainage
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Transplantation, Autologous

Substances

  • Antifungal Agents
  • Amphotericin B