A Diagnostic Dilemma: Similarity of Neuroradiological Findings in Central Nervous System Hemophagocytic Lymphohistiocytosis and Aspergillosis

Pediatr Blood Cancer. 2016 Jul;63(7):1296-9. doi: 10.1002/pbc.25967. Epub 2016 Mar 10.

Abstract

Central nervous system (CNS) involvement in the context of hemophagocytic lymphohistiocytosis (HLH) is not uncommon. Given the immunosuppressive nature of HLH therapy, infectious complications are also seen. We describe a 9-year-old male who developed acute neurological decline secondary to aspergillosis while undergoing HLH therapy. The significant overlap observed in CNS neuroimaging of HLH and aspergillosis and the subtleties that may help differentiate the two are discussed. The importance of obtaining tissue for definitive diagnosis is underscored.

Keywords: aspergillus; central nervous system; hemophagocytic lymphohistiocytosis.

Publication types

  • Case Reports

MeSH terms

  • Aspergillosis / diagnosis*
  • Aspergillosis / diagnostic imaging
  • Aspergillosis / therapy
  • Central Nervous System Diseases / diagnosis*
  • Central Nervous System Diseases / diagnostic imaging
  • Central Nervous System Diseases / therapy
  • Child
  • Humans
  • Lymphohistiocytosis, Hemophagocytic / diagnosis*
  • Lymphohistiocytosis, Hemophagocytic / diagnostic imaging
  • Lymphohistiocytosis, Hemophagocytic / therapy
  • Male
  • Neuroimaging