title: Post-traumatic intracranial epidural Aspergillus fumigatus abscess.
abstract: We report an intracranial epidural abscess caused by Aspergillus fumigatus in an immunocompetent patient. Infection occurred in a 20-year-old man 2 months after a frontal craniotomy following trauma. The abscess was encapsulated by a thickened dura and although the fungus did not invade the brain, frontal bone was infected and the patient presented with a subcutaneous frontal cellulitis. Initial management combined surgical drainage, resection of necrotic bone and liposomal amphotericin B (1 mg kg-1 per day). After 3 weeks of antifungal treatment a second evaluation surgery was performed. A clinically and radiologically unsuspected new abscess was found and evacuated. Treatment was completed with instillation into the cavity of amphotericin B at a concentration of 5 mg ml-1 and prolonged oral itraconazole (400-600 mg day-1). Treatment was successful and the patient is free of infection after 3 years.
authors.affiliation: Institut de Parasitologie et de Pathologie Tropicale, Strasbourg, France.
authors.forename: V
authors.initials: V
authors.lastname: Letscher
authors.forename: R
authors.initials: R
authors.lastname: Herbrecht
authors.forename: J
authors.initials: J
authors.lastname: Gaudias
authors.forename: G
authors.initials: G
authors.lastname: Taglang
authors.forename: H
authors.initials: H
authors.lastname: Koenig
authors.forename: M G
authors.initials: MG
authors.lastname: Dupuis
authors.forename: J
authors.initials: J
authors.lastname: Waller
mesh_terms: D000038:Abscess / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000063:Accidents, Traffic; D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001228:Aspergillosis / Q000209:etiology* / Q000628:therapy; D001232:Aspergillus fumigatus; D003399:Craniotomy; D004337:Drug Carriers; D004824:Epidural Space; D006801:Humans; D008081:Liposomes; D008279:Magnetic Resonance Imaging; D008297:Male; D011183:Postoperative Complications; D012887:Skull Fractures / Q000601:surgery*
chemical_list: D000935:Antifungal Agents; D004337:Drug Carriers; D008081:Liposomes; D000666:Amphotericin B