title: Posaconazole responsive cerebral aspergillosis in an immunocompetent adult.
abstract: Cerebral aspergillosis is a rare manifestation of invasive aspergillosis that usually affects immunocompromised patients. There are few treatment options for recurrent disease and experiences with immunocompetent patients are lacking. We report the clinical course of an immunocompetent patient with recurrent cerebral aspergillosis, following initial treatment with burr hole aspiration and voriconazole, who showed remarkable response to posaconazole. The patient remains clinically well with no evidence of recurrence on MRI 7 years following diagnosis. To our knowledge this is the first reported experience with posaconazole in an immunocompetent patient with cerebral aspergillosis.
authors.affiliation: Neurosurgery Department, The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool, L9 7LJ, UK. Electronic address: jellenbogen@doctors.org.uk.
authors.forename: Jonathan Richard
authors.initials: JR
authors.lastname: Ellenbogen
authors.affiliation: School of Medicine, University of Liverpool, Liverpool, UK.
authors.forename: Mueez
authors.initials: M
authors.lastname: Waqar
authors.affiliation: Department of Medicine and Medical Mycology, University Hospital of South Manchester, Manchester, UK.
authors.forename: David W
authors.initials: DW
authors.lastname: Denning
authors.affiliation: Microbiology Department, Aintree University Hospital NHS Foundation, Liverpool, UK.
authors.forename: Richard P D
authors.initials: RP
authors.lastname: Cooke
authors.affiliation: Otolaryngology Department, The Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK.
authors.forename: Derek W
authors.initials: DW
authors.lastname: Skinner
authors.affiliation: Otolaryngology Department, Aintree University Hospital NHS Foundation, Liverpool, UK.
authors.forename: Tristram
authors.initials: T
authors.lastname: Lesser
authors.affiliation: Neurosurgery Department, Beaumont Hospital, Dublin, Ireland.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Javadpour
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D001921:Brain / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D004660:Encephalitis / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013396:Suction; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*; D065819:Voriconazole / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D014230:Triazoles; C101425:posaconazole; D065819:Voriconazole
keywords: Aspergillosis; Central nervous system; Immunocompetent; Posaconazole; Voriconazole