title: Response of central nervous system aspergillosis to voriconazole.
abstract: Fungal infections of the central nervous system (CNS) usually present as subacute meningitis. Other manifestations include mass effect and focal neurological deficits. Cerebrospinal fluid (CSF) examination and biopsy of the lesion are helpful in disclosing the organism involved. Aspergillosis presents as brain abscess or granuloma with predominant neutrophils in CSF. Voriconazole is a broad spectrum triazole antifungal agent. It can be given orally and has lesser adverse effects We report a 69-years-old diabetic male, with aspergilloma of para-nasal sinus invading the CNS, who responded well to voriconazole treatment. He discontinued the medication by himself as it was costly. Within a month of stopping the medication, he developed features of subacute meningitis. However he showed clinical improvement after the medication was restarted. The case is reported for the clinical evidence of antifungal activity of voriconazole against aspergillosis.
authors.affiliation: Department of Neurology, PSG Institute of Medical Sciences and Research, Avinasi Road, Peelamedu, Coimbatore - 641 002, India.
authors.forename: Prakash
authors.initials: P
authors.lastname: Balasubramaniam
authors.forename: Pranesh B
authors.initials: PB
authors.lastname: Madakira
authors.forename: Anish
authors.initials: A
authors.lastname: Ninan
authors.forename: Aarthi
authors.initials: A
authors.lastname: Swaminathan
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020953:Neuroaspergillosis / Q000188:drug therapy* / Q000473:pathology; D010256:Paranasal Sinuses / Q000382:microbiology / Q000473:pathology; D011743:Pyrimidines / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014230:Triazoles / Q000627:therapeutic use*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole