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Journal of the Korean Neurological Association 1998;16(1): 87-90.
대뇌경색을 동반한 Aspergillus 뇌농양 1례
김상수, 정재익 차재관 김상호 김재우 김형동*
동아대학교 의과대학 신경과학 교실 신경외과학 교실*
A Case of Intracerebral Aspergillus Abscess Presenting as Cerebral Infarction
Sang-Su Kim, M.D., Jae-Ik Jeong, M.D., Jae-Kwan Cha, M.D., Sang-Ho Kim, M.D., Jae-Woo Kim, M.D., Hyung-Dong Kim, M.D.*
Department of Neurology & Neurosurgery* Dong-A University College of Medicine
Abstract
Background and Significance : Fungal infection of the central nervous system can be attributable to Cryptococcus, Nocardia, Mucor, Candida, and rarely Aspergillus. The types of nervous system involvement by Aspergillus can be divided into 4 groups : meningitis, meningoencephalitis, brain abscess, and single solid granuloma. Aspergillosis involving the central nervous system is a rare disease. Aspergillosis presenting as cerebral infarction has been rarely reported. We experienced one case of intracerebral abscess caused by Aspergillus, presenting as cerebral infarction. Case : A 54-year-old male, with a history of diabetes mellitus for 7 years, was admitted with headache for 1 month. Initial CSF findings showed pleocytosis(180/ul), and increased protein(79mg/dl). On the 2nd admission day, the patient showed left hemiparesis, left facial palsy of central type and drowsiness. Brain MRI revealed right MCA infarction. Neurologic status was stationary for almost 2wks. The WBC count of CSF was increased to 1150/ul on the 14th admission day, and antituberculous medication was started. On the 27th admission day, deep drowsy mentality was noted. Treatment with steroid was done and then mentality was improved to drowsiness. Brain abscess was found in right frontotemporal area and there were herniation signs on the 29th admssion day. Aspiration was done. Aspergillus fumigatus was grown on fungus culture of CSF and amphotericin B was started. Conclusion : We report a rare case of intracerebral Aspergillosis, manifested by right MCA infarction and brain abscess.