Brain, Aspergillus abscess [LMP19591]

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Diagnostic Modality: 
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Disease Category: 
Infectious Diseases
Diagnosis: 
Aspergillus abscess
Species: 
Human
Organ System: 
Central Nervous System
Gender: 
Male
Age: 
55 years
Diagnosis Code: 
ICD-10: B44.8
Slide Contributor Information
Gao, A., Munoz, D.

Keywords

Aspergilloma, fungus, fungal infection

Clinical History

55-year-old man with past medical history of chronic lymphocytic leukemia presents with headache. Neuroimaging shows multiple ring-enhancing lesions in the brain.

Clinical Discussion

CNS involvement by fungal organisms such as Aspergillus is typically a complication of systemic disease, most often occurring in immunocompromised patients. Organisms may spread to the CNS hematogenously, typically following pulmonary disease, or may directly invade the CNS following sinonasal infection. The outcome is poor in many patients, even with treatment. Microscopically, Aspergillus shows dichotomous, acute-angle branching hyphae that stain positively with PAS and GMS. However, correlation with tissue culture is essential, and in this case Aspergillus fumigatus was confirmed. The inflammatory reaction in the adjacent brain varies depending on the immunocompetency of the patient.