Ces radiol. 2007, 61(3):295-299

Cerebral aspergillosis in patients with haematologic malignanciesCase report

Hynek Mírka¹, Jan Kastner¹, Kristýna Ohlídalová¹, Jana Koudelová¹, Daniel Lysák², Michal Karas², Petr Mukenšnabl³, Pavla Veselá³

¹ RDG klinika LF UK a FN, Plzeň

² Hematoonkologické oddělení FN, Plzeň

³ Šiklův patologicko-anatomický ústav LF UK a FN, Plzeň

Introduction: Cerebral aspergillosis is one of the most serious infectious complications in patients with severe immunodeficiency. Imaging findings of cerebral aspergillosis are discussed. The mortality rate is higher than 80 %. Infection is usually spread to the brain from the lungs and paranasal sinuses. Cerebral infarction is the most common early feature in this group of patients.


Case study. The authors present three cases of cerebral aspergillosis in patients with hematologic malignancy. Cerebral infarction was the first manifestation of the disease in all of them. In one case the infarcts were multiple. In two cases they were haemorrhagic. Only one patient with a less severe immunodeficit survived. The remaining two patients died shortly after the diagnosis. A pulmonary lesion was present in all patients.

Conclusion: Infarction is usually the first symptom of cerebral aspergillosis in severe immunocompromised hosts. Frequently, (but this is not obligatory) a pulmonary lesion is simultaneously present, which may be helpful in establishing a differential diagnosis. The diagnosis of cerebral infartion in high-risk patients is an indication for intensive antifungal treatment.

Keywords: aspergillus, immunocompromised host, magnetic resonance maging, brain infarction, computed tomography

Accepted: July 10, 2007; Published: September 1, 2007  Show citation