Case Report
1 Medical Student at Medical College of Wisconsin, Milwaukee, Wisconsin, USA
2 Graduate of Drake University, Biochemistry, Cell & Molecular Biology, Chemistry, Des Moines, Iowa, USA
3 Associate Professor, Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
4 Assistant Professor, Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
Address correspondence to:
Sarah C Kurkowski
4359 S 110th Street, Greenfield, WI 53228,
USA
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Article ID: 100069Z09SK2022
Introduction: There are currently very few documented case reports of Aspergillus brain abscesses in the setting of persistent sinusitis symptoms and comorbid conditions of Type II Diabetes Mellitus and steroid treatment. Many cases of intracranial aspergillosis are secondary to a disseminated invasive Aspergillus infection or primary pulmonary aspergillosis. This case illustrates the importance and vitality of considering the rare but potentially lethal diagnosis of Aspergillus fumigatus brain abscess in the differential of persistent sinusitis, even in the absence of systemic symptoms.
Case Report: A 73-year-old female with risk factors of Type II Diabetes Mellitus (T2DM) and steroid treatment presented to the hospital with persistent sinusitis symptoms lasting three months. She subsequently was diagnosed with Aspergillus brain abscess after bicoronal bifrontal craniotomy with pericranial flap. The patient was treated with voriconazole and amphotericin B for 3–6 months post-resection and follow-up with neurosurgery to monitor abscess reduction. She was admitted five more times after initial diagnosis for sequelae related to the brain abscess. The initial abscess did decrease in size but then began to worsen. The patient unfortunately passed away six months after initial presentation and diagnosis.
Conclusion: Few cases of invasive rhino-orbito-cerebral Aspergillus brain abscesses secondary to Aspergillus sinus infections have been documented. If missed it can be lethal. Therefore, when a patient presents with persistent sinusitis, in the relevant context, Aspergillus brain abscesses are an important differential diagnosis that warrant consideration.
Keywords: Aspergillus brain abscess, Aspergillus fumigatus, Aspergillus sinusitis, Immunocompromised
Sarah C Kurkowski - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Michael J Thimmesch - Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Pinky Jha - Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Yasir H Abdelgadir - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Sarah C Kurkowski et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.