Aspergillus meningitis in a patient with chronic lymphocytic leukemia

J Infect Chemother. 2020 Jun;26(6):622-624. doi: 10.1016/j.jiac.2020.01.012. Epub 2020 Mar 3.

Abstract

Central nervous system aspergillosis is relatively rare and difficult to diagnose. Here, we report a case of 90-year-old man with chronic lymphocytic leukemia who presented with a month-long gradually worsening headache followed by 3 days of low-grade fever associated with altered mental status. Aspergillus meningitis diagnosed using Aspergillus galactomannan antigen in the cerebrospinal fluid and treated with voriconazole. Delayed diagnosis and treatment of Aspergillus meningitis is typically associated with high mortality; therefore, it is imperative to include this disease in the differential diagnoses of subacute meningitis.

Keywords: Aspergillus meningitis; CNS aspergillosis; Galactomannan.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antifungal Agents / therapeutic use
  • Antigens, Fungal / cerebrospinal fluid*
  • Aspergillosis / diagnosis*
  • Aspergillosis / drug therapy
  • Diagnosis, Differential
  • Galactose / analogs & derivatives
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / complications
  • Male
  • Mannans / cerebrospinal fluid*
  • Meningitis, Fungal / diagnosis*
  • Meningitis, Fungal / drug therapy
  • Voriconazole / therapeutic use

Substances

  • Antifungal Agents
  • Antigens, Fungal
  • Mannans
  • galactomannan
  • Voriconazole
  • Galactose

Supplementary concepts

  • Aspergillus meningitis