Cerebral Aspergillosis in a Diabetic Patient Leading to Cerebral Artery Occlusion and Ischemic Stroke: A Case Report and Literature Review

Cerebral aspergillosis is a rare and highly fatal hematogenous infection most commonly found in immune compromised patients. From the onset of neurologic symptoms, the median reported rate of survival is between 5 and 9 days. Compounded with increased hemorrhagic risks and the lack of specificity in...

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Bibliographic Details
Published in:Journal of stroke and cerebrovascular diseases 2015, Vol.24 (1), p.e39-e43
Main Authors: Li, Wentao, BA, Shafi, Neelofer, MD, Periakaruppan, Ramayee, MD, Valyi-Nagy, Tibor, MD, PhD, Groth, John, MD, Testai, Fernando D., MD, PhD, FAHA
Format: Article
Language:English
Subjects:
angioinvasive aspergillosis
Brain Diseases - complications
Brain Diseases - pathology
Brain Ischemia - etiology
Brain Ischemia - pathology
Cardiovascular
carotid occlusion
Cerebral aspergillosis
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - pathology
Fatal Outcome
Female
Humans
Middle Aged
Neuroaspergillosis - complications
Neuroaspergillosis - pathology
Neurology
stroke
Stroke - etiology
Stroke - pathology
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Summary:Cerebral aspergillosis is a rare and highly fatal hematogenous infection most commonly found in immune compromised patients. From the onset of neurologic symptoms, the median reported rate of survival is between 5 and 9 days. Compounded with increased hemorrhagic risks and the lack of specificity in both clinical presentation and traditional imaging, a fast and noninvasive method of definitive diagnosis is necessary if there is to be any hope for positive outcomes. We describe the case of a 50-year-old female diabetic with a history of otitis media, an uncharacterized inflammatory nasopharyngeal process, and prior ischemic strokes who presented with a new cerebral infarction in the setting of an angioinvasive fungal infection of the large cerebral arteries. We also present a literature review of aspergillosis detection and treatment in hopes that future cases will be diagnosed in a timely manner and more patients may be saved.
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2014.08.025