Multiple Brain Abscesses Due to Aspergillus Fumigatus in a Patient With Liver Cirrhosis: A Case Report

Medicine (Baltimore). 2016 Mar;95(9):e2813. doi: 10.1097/MD.0000000000002813.

Abstract

Invasive cerebral aspergillosis always developed in immunocompromised host. Early diagnosis may save life in this critical condition; however, it is difficult to reach. Herein, we presented an unusual case of invasive cerebral aspergillosis in a cirrhotic patient. A 47-year-old man presented with progressive deterioration of consciousness for three days. The patient had a history of alcoholic liver cirrhosis, Child-Pugh class C. Magnetic resonance imaging (MRI) of brain showed multi-focal parenchymal lesions, which was consistent with multiple brain abscesses. The diagnosis of invasive cerebral aspergillosis was made by molecular based laboratory methods including Aspergillus galactomannan antigen assay and oligonucleotide array. Despite treatment with the antifungal agent, Amphotericin B, the patient died at the ninth day of hospitalization. Our findings suggest that liver cirrhosis can be one of risk factors of invasive cerebral aspergillosis, and support the diagnosing usefulness of MRI, Aspergillus galactomannan antigen assay, and oligonucleotide array.

Publication types

  • Case Reports

MeSH terms

  • Amphotericin B / administration & dosage*
  • Antifungal Agents / administration & dosage
  • Antigens, Fungal / analysis
  • Antigens, Fungal / cerebrospinal fluid
  • Aspergillus fumigatus / immunology*
  • Brain Abscess* / complications
  • Brain Abscess* / diagnosis
  • Brain Abscess* / drug therapy
  • Brain Abscess* / microbiology
  • Fatal Outcome
  • Humans
  • Liver Cirrhosis / complications*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Oligonucleotide Array Sequence Analysis / methods

Substances

  • Antifungal Agents
  • Antigens, Fungal
  • Amphotericin B