title: Cerebral aspergillosis: a retrospective analysis of eight cases.
abstract: OBJECTIVE
  Aspergillosis of the central nervous system is very rare. However with recent increases in the use of immunosuppressive agents and antibiotics, its incidence is increasing. We evaluated the demographics, clinical manifestations, laboratory findings, diagnosis, underlying conditions, treatment regimens and outcomes of patients with cerebral aspergillosis (CA).
  
  
  METHODS
  We retrospectively reviewed data from eight patients with CA hospitalized at a Chinese general hospital from 1 January 2005 to 30 September 2015.
  
  
  RESULTS
  Common clinical manifestations included headache and cranial nerve involvement. Four patients underwent biopsy and were pathologically diagnosed with Aspergillus hyphae. One patient was proved to have Aspergillus infection via autopsy. One patient had positive cerebrospinal fluid fungal cultures. The lesion locations were: the cavernous sinus (n = 5, 62.5%), frontal lobe (n = 1, 12.5%), temporosphenoid lobe (n = 1, 12.5%) and cerebellum (n = 1, 12.5%). At the end of follow-up, three patients were cured and five patients had died (mortality rate, 62.5%).
  
  
  CONCLUSIONS
  Most patients with CA had no significant immunosuppression-related conditions in our study. Aspergillus spp. can infect the central nervous system through several pathways and CA has an atypical clinical manifestation. The use of local tissue puncture, surgery or other invasive means to obtain diseased tissue containing higher levels of Aspergillus, followed by culture or histological examination, can contribute to an early diagnosis of CA and timely therapeutic intervention. The prognosis of CA is poor, but early and adequate use of antifungal drugs with high transfer across the blood-brain barrier and radical surgery to remove lesions can improve the survival rate.
authors.affiliation: a Department of Neurology , General Hospital of the People 's Liberation Army , Beijing , China.
authors.forename: Ruo-Xi
authors.initials: RX
authors.lastname: Wang
authors.affiliation: a Department of Neurology , General Hospital of the People 's Liberation Army , Beijing , China.
authors.forename: Jia-Tang
authors.initials: JT
authors.lastname: Zhang
authors.affiliation: a Department of Neurology , General Hospital of the People 's Liberation Army , Beijing , China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.affiliation: a Department of Neurology , General Hospital of the People 's Liberation Army , Beijing , China.
authors.forename: Xu-Sheng
authors.initials: XS
authors.lastname: Huang
authors.affiliation: a Department of Neurology , General Hospital of the People 's Liberation Army , Beijing , China.
authors.forename: Wei-Quan
authors.initials: WQ
authors.lastname: Jia
authors.affiliation: a Department of Neurology , General Hospital of the People 's Liberation Army , Beijing , China.
authors.forename: Sheng-Yuan
authors.initials: SY
authors.lastname: Yu
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000134:cerebrospinal fluid / Q000150:complications* / Q000473:pathology* / Q000628:therapy*; D002540:Cerebral Cortex / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000935:Antifungal Agents
keywords: antifungal drug; aspergillosis; central nervous system; cerebral aspergillosis; fungal infection