title: Management of granulomatous cerebral aspergillosis in immunocompetent adult patients: a review.
abstract: Cerebral aspergillosis, is an infrequent, opportunistic infection of the central nervous system that accounts for 5-10% of all intracranial fungal pathology. It is uncommon in immunocompetent patients and has a significant disease burden, with high morbidity and mortality, even with appropriate treatment. Basic principles of abscess management should be employed, including aspiration and targeted anti-fungal therapy for 12-18 months. However, reported outcomes with a purely minimally invasive approach are poor and there should be a low threshold for surgical excision, especially in resource poor settings and in patients with deteriorating neurology harbouring sizeable masses. Evidence favouring gross total excision over subtotal resection is lacking, however. It is notable that these recommendations are largely based on retrospective case series and isolated case reports. There is a need therefore for international collaboration to evaluate management strategies for immunocompetent patients with cerebral aspergillosis.
authors: a Neurosurgery Department , the Walton Centre NHS Foundation Trust , Liverpool , UK ;
authors: Jonathan Richard
authors: JR
authors: Ellenbogen
authors: b Institute of Infection and Global Health , University of Liverpool , Liverpool , UK ;
authors: Mueez
authors: M
authors: Waqar
authors: c Microbiology Department , Alder Hey Children's NHS Foundation Trust , Liverpool , UK ;
authors: Richard P D
authors: RP
authors: Cooke
authors: d Neurosurgery Department , Beaumont Hospital , Dublin , Ireland.
authors: Mohsen
authors: M
authors: Javadpour
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy* / Q000276:immunology / Q000601:surgery; D002490:Central Nervous System / Q000473:pathology / Q000601:surgery*; D006801:Humans; D009422:Nervous System Diseases / Q000188:drug therapy* / Q000276:immunology / Q000601:surgery*; D011182:Postoperative Care; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents
keywords: Antifungal agents; Aspergillus; management; neuroaspergillosis