title: Cerebral aspergillosis in a diabetic patient leading to cerebral artery occlusion and ischemic stroke: a case report and literature review.
abstract: Cerebral aspergillosis is a rare and highly fatal hematogenous infection most commonly found in immune compromised patients. From the onset of neurologic symptoms, the median reported rate of survival is between 5 and 9 days. Compounded with increased hemorrhagic risks and the lack of specificity in both clinical presentation and traditional imaging, a fast and noninvasive method of definitive diagnosis is necessary if there is to be any hope for positive outcomes. We describe the case of a 50-year-old female diabetic with a history of otitis media, an uncharacterized inflammatory nasopharyngeal process, and prior ischemic strokes who presented with a new cerebral infarction in the setting of an angioinvasive fungal infection of the large cerebral arteries. We also present a literature review of aspergillosis detection and treatment in hopes that future cases will be diagnosed in a timely manner and more patients may be saved.
authors.affiliation: Department of Neurology, University of Illinois College of Medicine, Chicago, Illinois.
authors.forename: Wentao
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Neurology, University of Illinois College of Medicine, Chicago, Illinois.
authors.forename: Neelofer
authors.initials: N
authors.lastname: Shafi
authors.affiliation: Department of Pathology, University of Illinois College of Medicine, Chicago, Illinois.
authors.forename: Ramayee
authors.initials: R
authors.lastname: Periakaruppan
authors.affiliation: Department of Pathology, University of Illinois College of Medicine, Chicago, Illinois.
authors.forename: Tibor
authors.initials: T
authors.lastname: Valyi-Nagy
authors.affiliation: Department of Pathology, University of Illinois College of Medicine, Chicago, Illinois.
authors.forename: John
authors.initials: J
authors.lastname: Groth
authors.affiliation: Department of Neurology, University of Illinois College of Medicine, Chicago, Illinois. Electronic address: testai@uic.edu.
authors.forename: Fernando D
authors.initials: FD
authors.lastname: Testai
mesh_terms: D001927:Brain Diseases / Q000150:complications* / Q000473:pathology; D002545:Brain Ischemia / Q000209:etiology* / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D020953:Neuroaspergillosis / Q000150:complications* / Q000473:pathology; D020521:Stroke / Q000209:etiology* / Q000473:pathology
keywords: Cerebral aspergillosis; angioinvasive aspergillosis; carotid occlusion; stroke