Intracranial Fungal Infection After Solid-Organ Transplant

Exp Clin Transplant. 2018 Mar;16 Suppl 1(Suppl 1):179-182. doi: 10.6002/ect.TOND-TDTD2017.P56.

Abstract

Neurologic complications after solid-organ transplant reveal a great spectrum of pathologies. Intracranial hemorrhages, cerebral ischemic lesions, infarctions, lymphoproliferative disorders, and infections, including aspergillosis, have been observed after liver transplant. Fungi constitute nearly 5% of all central nervous system infections, mainly occurring in immunocompromised patients. The most common causative agent is Aspergillus species. It presents either as maxillary sinusitis or pulmonary infection. Brain involvement of Aspergillus carries a high rate of mortality. Aspergillosis presents in the forms of meningitis, mycotic aneurysms, infarctions, and mass lesions. Aspergillosis does not have a specific radiologic appearance. Parenchymal aspergillosis has heterogenous signal intensity (hypointense on T1-weighted and hyperintense on T2-weighted images). Here, we present 3 patients who underwent solid-organ transplant and developed central nervous system aspergillosis. Different modalities of neurosurgical intervention were performed in combination with chemotherapy as part of their fungal therapy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use
  • Brain Abscess / diagnostic imaging
  • Brain Abscess / drug therapy
  • Brain Abscess / immunology
  • Brain Abscess / microbiology*
  • Female
  • Humans
  • Hydrocephalus / diagnostic imaging
  • Hydrocephalus / drug therapy
  • Hydrocephalus / immunology
  • Hydrocephalus / microbiology*
  • Immunocompromised Host
  • Immunosuppressive Agents / adverse effects
  • Kidney Transplantation / adverse effects*
  • Liver Transplantation / adverse effects*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuroaspergillosis / diagnostic imaging
  • Neuroaspergillosis / drug therapy
  • Neuroaspergillosis / immunology
  • Neuroaspergillosis / microbiology*
  • Opportunistic Infections / diagnostic imaging
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / immunology
  • Opportunistic Infections / microbiology*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Immunosuppressive Agents