title: Multiple Brain Abscesses Due to Aspergillus Fumigatus in a Patient With Liver Cirrhosis: A Case Report.
abstract: Invasive cerebral aspergillosis always developed in immunocompromised host. Early diagnosis may save life in this critical condition; however, it is difficult to reach. Herein, we presented an unusual case of invasive cerebral aspergillosis in a cirrhotic patient. A 47-year-old man presented with progressive deterioration of consciousness for three days. The patient had a history of alcoholic liver cirrhosis, Child-Pugh class C. Magnetic resonance imaging (MRI) of brain showed multi-focal parenchymal lesions, which was consistent with multiple brain abscesses. The diagnosis of invasive cerebral aspergillosis was made by molecular based laboratory methods including Aspergillus galactomannan antigen assay and oligonucleotide array. Despite treatment with the antifungal agent, Amphotericin B, the patient died at the ninth day of hospitalization. Our findings suggest that liver cirrhosis can be one of risk factors of invasive cerebral aspergillosis, and support the diagnosing usefulness of MRI, Aspergillus galactomannan antigen assay, and oligonucleotide array.
authors.affiliation: From the Department of Medicine (H-JT), Chi Mei Medical Center, Tainan, and Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan; Department of Intensive Care Medicine (WWL, CCL), Chi Mei Medical Center, Liouying, Tainan; Department of Medical Laboratory Science and Biotechnology (TCC), College of Medicine, National Cheng Kung University, Tainan; Department of Internal Medicine (M-CL, W-CK, C-JW), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan; National Institute of Infectious Diseases and Vaccinology (C-JW), National Health Research Institutes, Tainan; Department of Medical Research (Y-CC), Chi Mei Medical Center, Tainan; and Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
authors.forename: Hung-Jen
authors.initials: HJ
authors.lastname: Tang
authors.forename: Wei-Lun
authors.initials: WL
authors.lastname: Liu
authors.forename: Tsung Chain
authors.initials: TC
authors.lastname: Chang
authors.forename: Ming-Chi
authors.initials: MC
authors.lastname: Li
authors.forename: Wen-Chien
authors.initials: WC
authors.lastname: Ko
authors.forename: Chi-Jung
authors.initials: CJ
authors.lastname: Wu
authors.forename: Yin-Ching
authors.initials: YC
authors.lastname: Chuang
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Lai
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage*; D000935:Antifungal Agents / Q000008:administration & dosage; D000946:Antigens, Fungal / Q000032:analysis / Q000134:cerebrospinal fluid; D001232:Aspergillus fumigatus / Q000276:immunology*; D001922:Brain Abscess / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D017809:Fatal Outcome; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020411:Oligonucleotide Array Sequence Analysis / Q000379:methods
chemical_list: D000935:Antifungal Agents; D000946:Antigens, Fungal; D000666:Amphotericin B