Aspergillus meningitis in a patient with chronic lymphocytic leukemia

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. Asp...

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Bibliographic Details
Published in:Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2020-06, Vol.26 (6), p.622-624
Main Authors: Matsuo, Takahiro, Mori, Nobuyoshi, Sakurai, Aki, Furukawa, Keiichi
Format: Article
Language:English
Subjects:
Aged, 80 and over
Antifungal Agents - therapeutic use
Antigens, Fungal - cerebrospinal fluid
Aspergillosis - diagnosis
Aspergillosis - drug therapy
Aspergillus meningitis
CNS aspergillosis
Diagnosis, Differential
Galactomannan
Humans
Leukemia, Lymphocytic, Chronic, B-Cell - complications
Male
Mannans - cerebrospinal fluid
Meningitis, Fungal - diagnosis
Meningitis, Fungal - drug therapy
Voriconazole - therapeutic use
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Summary: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.
ISSN:1341-321X
1437-7780
DOI:10.1016/j.jiac.2020.01.012