Contrast enhanced CT scan of the brain showing unequivocally 2 hypodense lesions, one in the left basal ganglia and one in the right occipital cortex. There is the possibility of another smaller left sided occiptal cortex. These lesions do not have the appearance of abscesses, but rather of ischaema.
Patient diagnosed with Stage C Chronic Lymphocytic Leukaemia, treated in the MRC CLL4 study, with prednisolone for 4 weeks followed by oral chlorambucil for 7 days. Patient developed severe pneumonia due to pseudomonas and staphylococcus. Following treatment with broad spectrum antibiotics and 1 week of Abelcet, patient was readmitted with headache, disorientation and fever. CT brain scans showed 3 ring enhancing lesions, aspirated material showed neutrophils but grew aspergillus. Patient now improved on Abelcet (4 mg/kg) and oral itrconazole suspension 200mg b.d.
Thanks to Richard Chasty, Consultant Haematologist, North Staffordsire Hospital, UK.
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![Asp[1]niger](https://www.aspergillus.org.uk/wp-content/uploads/2013/11/Asp1niger-150x150.gif "Asp[1]niger")
