Aspergillus meningitis: a rare clinical manifestation of central nervous system aspergillosis. Case report and review of 92 cases.

Abstract

OBJECTIVES:

To describe the pathogenesis, clinical presentation, cerebrospinal fluid findings and outcome of Aspergillus meningitis, meningoencephalitis and arachnoiditis.

METHODS:

A case of Aspergillus meningitis is described. A comprehensive review of the English-language literature was conducted to identify all reported cases of Aspergillus meningitis described between January 1973 and December 2011.

RESULTS:

Ninety-three cases (including the one described herein) of Aspergillus meningitis were identified. Fifty-two (55.9%) were in individuals without any predisposing factor or known causes of immunosuppression. Acute and chronic meningitis was diagnosed in 65.6% of patients and meningoencephalitis in 24.7% of them with the remaining presenting with spinal arachnoiditis and ventriculitis. Cerebrospinal fluid cultures for Aspergillus spp. were positive in about 31% of cases and the galactomannan antigen test in 87%. Diagnosis during life was achieved in 52 patients (55.9%) with a case fatality rate of 50%. The overall case fatality rate was 72.1%.

CONCLUSIONS:

Aspergillus meningitis may occur in both immunocompetent and immunocompromised patients and run an acute or chronic course. The findings of this systematic review extend the information on this life-threatening infection and could assist physicians in achieving an improved outcome.

• Authors: Spinello Antinori, Mario Corbellino, Luca Meroni, Federico Resta, Salvatore Sollima, Massimo Tonolini, Anna Maria Tortorano, Laura Milazzo, Lorenzo Bello, Elisa Furfaro, Massimo Galli, Claudio Viscoli
• Journal: The Journal of infection (J Infect) Vol. 66 Issue 3 Pg. 218-38 (Mar 2013) ISSN: 1532-2742 [Electronic] England
• PMID: 23178421 (Publication Type: Case Reports, Journal Article, Review, Systematic Review)
• Copyright: Copyright © 2012 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Topics

• Adult
• Aspergillosis (microbiology, pathology)
• Aspergillus flavus (isolation & purification)
• Central Nervous System (microbiology, pathology)
• Cerebrospinal Fluid (microbiology)
• Female
• Humans
• Immunocompromised Host
• Male
• Meningitis, Fungal (microbiology, pathology)