Cerebral aspergillosis is an emerging serious and rare infection which diagnostic and therapeutic possibilities have improved in recent years.
We related a case of invasive aspergillosis complicated brain and skin lesions confirmed Aspergillus fumigatus.
62 years of women followed for hematologic malignancy in remission, under high-dose corticosteroid therapy is permitted for cerebral image (empyema) afebrile neutropenia posing an etiologic diagnosis problem .In recent history we find the notion of hospital a month ago for pulmonology antigenaemia pulmonary disease with negative LBA.
Under triple antibiotic therapy, persistence of brain injury with important mass effect having been referred to a location of his blood disease, cerebral toxoplasmosis, nocardiosis, cerebral tuberculosis, if not the presence of skin lesions type of scar sitting at the left cheek, brisket and the anterior aspect of the left thigh itchy, oozing sometimes the origin and date of onset are imprecise by the patient.
The analysis and culture samples of skin lesions confirmed the diagnosis of invasive aspergillosis .The non-response to amphotericin B (5semaines) and impaired renal function have led the development of the patient as itraconazole with a decline six-month evolution spectacular disappearance of the image, the edema and skin lesions
Conclusion : The originality lies with the fact that the skin lesions are present in approximately 5% of cases in the aspect of pustules with possible progression to necrosis. Usually metastatic, they can result from direct inoculation at a catheter inlet, drainage or at a surgical wound that is not the case in our patient but they helped straighten etiologic diagnosis of brain injury.
Full conference title:
- RICAI 34th (2014)