Isolated brain abscess caused by Aspergillus tubingensis in a patient with alcoholic liver cirrhosis.

A 67-year-old Japanese man with alcoholic liver cirrhosis without any other known immunosuppressive conditions presented with a solitary brain abscess caused by Aspergillus tubingensis. A. tubingensis, a cryptic species within the Aspergillus section Nigri, has been reported to exhibit resistance to voriconazole. This case highlights the necessity for considering central nervous system aspergillosis as a differential diagnosis, even in patients without significant immunosuppression. Moreover, molecular identification and antifungal susceptibility testing are crucial for accurate diagnosis and effective management of such infections, as cryptic species within the Aspergillus genus may exhibit varying degrees of resistance to established treatments.