An unexpected intracerebral lesion - case report of a superinfected aspergillosis mimicking a brain metastasis
| Autor: | Anna Maria Reuss, Elisabeth J. Rushing, Athina Pangalu, Markus Florian Oertel, Basil E Grüter |
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| Přispěvatelé: | University of Zurich, Grüter, Basil Erwin |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Pathology medicine.medical_specialty Antifungal Agents Staphylococcus medicine.medical_treatment 030106 microbiology Bacterial infections and mycoses 10208 Institute of Neuropathology Case Report 610 Medicine & health Infectious and parasitic diseases RC109-216 Aspergillosis Metastasis Diagnosis Differential Lesion Immunocompromised Host 03 medical and health sciences 10180 Clinic for Neurosurgery 0302 clinical medicine Central Nervous System Fungal Infections 10043 Clinic for Neuroradiology medicine Humans 030212 general & internal medicine Brain abscess Neuroaspergillosis Lung Brain Neoplasms business.industry Immunosuppression 2725 Infectious Diseases Middle Aged medicine.disease Aspergillus Infectious Diseases medicine.anatomical_structure Superinfection Female medicine.symptom Differential diagnosis business Brain metastasis |
| Zdroj: | BMC Infectious Diseases, Vol 21, Iss 1, Pp 1-5 (2021) BMC Infectious Diseases |
| Popis: | Background 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. Case presentation 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. Conclusions A high index of suspicion for aspergillus infection should be maintained in the setting of immunosuppression. Clinical and radiological findings are often unspecific and even misleading. Definite confirmation usually relies on tissue diagnosis with histochemical stains. Surgical resection is crucial for establishing the diagnosis and guiding therapy with targeted antifungal medications. |
| Databáze: | OpenAIRE |
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