Successful treatment of cerebral aspergillosis with a high oral dose of itraconazole after excisional surgery.
We report a case of cerebral aspergillosis which originated from the sphenoid sinus, and involved a progressive decrease of visual acuity. The neurological signs indicated a cavernous sinus invasion. After extensive intracranial surgery we treated the residual aspergillosis with a high oral dose of itraconazole (800 mg/d for 4 months, followed by 400 mg/d for 5 months). The neurological impairments of the patient gradually subsided with the resolution of the fungal lesion shown on MRI. The successful therapy indicated that itraconazole has a significant role in the treatment of advanced cerebral aspergillosis if it is used in high doses (16 mg/kg/d for adults).
Imai
T
T
Department of Neurology, School of Medicine, Sapporo Medical University.
Yamamoto
T
T
Tanaka
S
S
Kashiwagi
M
M
Chiba
S
S
Matsumoto
H
H
Uede
T
T
D000284:Administration, Oral; D000935:Antifungal Agents / Q000008:administration & dosage*; D001228:Aspergillosis / Q000188:drug therapy* / Q000601:surgery; D001922:Brain Abscess / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D002540:Cerebral Cortex / Q000382:microbiology; D003131:Combined Modality Therapy; D048909:Diabetes Complications; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged
D000935:Antifungal Agents; D017964:Itraconazole