A Case of Cerebral Aspergillosis Diagnosed by Magnetic Resonance Imaging and Antigen Test

Background: Aspergillosis involving central nervous system (CNS) is very rare. Recently we experienced an old woman with cerebral aspergillosis, in whom characteristic magnetic resonance imaging (MRI) findings and antigen test were helpful in diagnosis. Case Report: A 87-year-old woman was admitted to the hospital due to diminished cognition and abnormal behavior for two weeks. On brain MRI small multiple conglomerated granulomatous lesions with surrounding extensive vasogenic edema, and multifocal small hemorrhages were observed in right temporal area. Additionally, the titer of Aspergillus antigen test was highly increased. With intravenous antifungal agents the patient’s clinical symptoms were markedly improved. Conclusion: For CNS aspergillosis the urgent diagnosis followed by appropriate treatment is essential due to its high mortality. The characteristic brain MRI accompanied by high levels of aspergillosis antigen titer could be helpful diagnostic tool of CNS aspergillosis in special situations not being able to obtain pathologic confirmation. J Neurocrit Care 2013;6:111-114