A Rare Case of Invasive Central Nervous System Aspergillus niger in a Previously Immunocompetent Patient After Corticosteroid Treatment for COVID-19

Hussein Saleh; Peter Abraham; Hassan Chahine; Shanmuga Subbiah; Nadine Grace-Abraham

doi:10.7759/cureus.57923

A Rare Case of Invasive Central Nervous System Aspergillus niger in a Previously Immunocompetent Patient After Corticosteroid Treatment for COVID-19

Cureus. 2024 Apr 9;16(4):e57923. doi: 10.7759/cureus.57923. eCollection 2024 Apr.

Authors

Hussein Saleh¹, Peter Abraham², Hassan Chahine³, Shanmuga Subbiah⁴, Nadine Grace-Abraham⁵

Affiliations

¹ College of Osteopathic Medicine, Michigan State University, East Lansing, USA.
² Radiology, University of California San Diego, San Diego, USA.
³ Internal Medicine, Emanate Health, West Covina, USA.
⁴ Hematology and Oncology, Emanate Health, West Covina, USA.
⁵ Family Medicine, Loma Linda University, Loma Linda, USA.

Abstract

Aspergillus is a ubiquitous saprophyte found in air, soil, and organic matter. Humans inhale the spore form of the fungus, but manifestations of the disease are typically predominantly seen in immunocompromised patients. Invasive central nervous system (CNS) aspergillosis is even more uncommon, and epidemiological data is sparse, particularly in immunocompetent patients. We report the case of a 67-year-old previously immunocompetent female with no known comorbidities who was treated with corticosteroids for COVID-19 one month prior to admission for altered mental status (AMS). Subsequent imaging and biopsy demonstrated invasive CNS Aspergillus niger. Though a rare cause of AMS in immunocompetent patients, this report draws attention to the detrimental immunosuppressive effects of corticosteroid therapy in COVID-19.

Keywords: cns aspergilloma; covid-19; immunocompetent patients; invasive aspergillus; steroid use.

Publication types

Case Reports