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Open AccessCase Report

Central Nervous System Aspergillosis: An Unexpected Complication following Neurosurgery

1
Division of Infectious Diseases, Department of Medicine, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 863B, Miami, FL 33136, USA
2
Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
*
Author to whom correspondence should be addressed.
Diseases 2018, 6(2), 46; https://doi.org/10.3390/diseases6020046
Received: 19 May 2018 / Revised: 29 May 2018 / Accepted: 30 May 2018 / Published: 31 May 2018
(This article belongs to the Section Infectious Disease)
Post-surgical aspergillosis is an uncommon complication that carries a high mortality rate in affected patients. The diagnosis is challenging given the lack of highly sensitive methods to isolate Aspergillus from surgical sites. Here, we present a case of post-surgical aspergillosis that occurred after the resection of acoustic neuroma in an immunocompetent patient. Imaging revealed leptomeningeal enhancement and a cerebellar extra-axial fluid collection adjacent to the right retrosigmoid craniotomy. The patient was taken to the operating room for debridement, where purulent fluid was obtained from subdural space. The diagnosis was achieved by histopathology and polymerase chain reaction (PCR) in brain tissue. Appropriate investigations failed to detect contamination in the operating room. The patient was successfully treated with 3 months of voriconazole. We highlight the importance of recognizing this uncommon complication and advocate for the use of molecular techniques to improve the diagnostic yield in central nervous system aspergillosis. View Full-Text
Keywords: post-surgical; central nervous system; Aspergillus; PCR; voriconazole post-surgical; central nervous system; Aspergillus; PCR; voriconazole
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Gonzales Zamora, J.A.; Henry, Z.; Gultekin, S.H. Central Nervous System Aspergillosis: An Unexpected Complication following Neurosurgery. Diseases 2018, 6, 46.

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