Journal of Postgraduate Medicine
 Open access journal indexed with Index Medicus & ISI's SCI  
Users online: 614  
Home | Subscribe | Feedback | Login 
About Latest Articles Back-Issues Article Submission Resources Sections Etcetera Contact
 
  NAVIGATE Here 
 ::   Next article
 ::   Previous article
 ::   Table of Contents

 RESOURCE Links
 ::   Similar in PUBMED
 ::  Search Pubmed for
 ::  Search in Google Scholar for
 ::Related articles
 ::   Citation Manager
 ::   Access Statistics
 ::   Reader Comments
 ::   Email Alert *
 ::   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed17016    
    Printed567    
    Emailed19    
    PDF Downloaded1130    
    Comments [Add]    
    Cited by others 37    

Recommend this journal


 

 REVIEW ARTICLE
Year : 2005  |  Volume : 51  |  Issue : 5  |  Page : 37-41

Aspergilloma of the brain: an overview


Department of Neurosurgery, Seth G. S. Medical College, King Edward Memorial Hospital, Parel, Mumbai, India

Correspondence Address:
T Nadkarni
Department of Neurosurgery, Seth G. S. Medical College, King Edward Memorial Hospital, Parel, Mumbai
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


PMID: 16519254

Rights and PermissionsRights and Permissions

Fungal infections of the central nervous system (CNS) are almost always a clinical surprise. Their presentation is subtle, often without any diagnostic characteristics, and they are frequently mistaken for tuberculous meningitis, pyogenic abscess, or brain tumor. Granulocytopenia, cellular and humoral mediated immune dysfunction are predisposing factors to the development of CNS infections in immunosuppressed patients. Aspergillus fumigatus is the most common human pathogen in the genus Aspergillus .Maxillary sinusitis of dental origin or the lungs are the most common sites of primary Aspergillus infection. Infection reaches the brain directly from the nasal sinuses via vascular channels or is blood borne from the lungs and gastrointestinal tract. Single or multiple abscess formation with blood vessel invasion leading to thrombosis is a characteristic feature of Aspergillosis on neuropathologic examination. Aspergillosis should be considered in cases manifesting with acute onset of focal neurologic deficits resulting from a suspected vascular or space-occupying lesion especially in immunocompromised hosts. Aspergillosis is diagnosed on direct examinations and culture, however the diagnosis of aspergillosis of the CNS is difficult. Diagnosis of an intracranial mass lesion is best confirmed with a computed tomography or magnetic resonance imaging of the head with or without intravenous contrast. Aggressive neurosurgical intervention for surgical removal of Aspergillus abscesses, granulomas, and focally infracted brain; correction of underlying risk factors; Amphotericin B combined with flucytosine and treatment of the source of infection should form the mainstay of the management. Off late Liposomal Amphotericin B was found to be more effective and safe than conventional Amphotericin B in the management of Apergillus infections Only with a high index of suspicion, an aggressive approach to diagnosis, and rapid vigorous therapy may we hope to alter the clinical course in this group of patients.






[FULL TEXT] [PDF]*


        
Print this article     Email this article

Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow