Intracranial Aspergillus Fungal Granuloma: Local Experience

Background: Fungal infections of the brain are almost always a surprising finding. Their presentation is usually subtle, often without any diagnostic characteristics, and they are frequently mistaken for pyogenic abscesses, or brain tumors. Aspergillosis of the brain is an uncommon infection, mainly occurring in immunocompromised patients. Objective: The aim of this study was to present our local experience with eight consecutive patients with rare intracranial granuloma due to aspergillus fungus infection. Patients and Methods: The authors reviewed their clinic data archive from 2004 through 2016, and eight patients who harbored intracranial aspergillus fungal granuloma were enrolled. Patients symptoms, radiographs, intraoperative findings, and clinical results were evaluated. All patients underwent surgical debridement. Results: There were four men and four women included in the study, with a mean age of 24 years (range 17–34 years). Headache, fever and symptoms of increased intracranial pressure were the predominant symptoms. Predisposing factors were diabetes in three patients and immunocompromise related to non-Hodgkin s lymphoma in one patient. Location was primarily frontal with anterior cranial fossa involved in all cases. Six patients had paranasal sinus involvement. All the patients underwent craniotomy for resection. Mortality was in three patients (37.5%). Conclusion: Our small series highlights the clinical features of aspergillus fungal granuloma of the brain. Surgical debridement augments antifungal drugs by removal of necrotic debris.