Zhou Zhiwei, Hu Xueqin, Wang Jingwen, Wang Nianhua
Department of Neurosurgery, Xiangya School of Medicine, The First People's Hospital of Changde City, Central South University, Changde, Hunan, 415003, China.
Department of Obstetrics and Gynecology, Xiangya School of Medicine, The First People's Hospital of Changde City, Central South University, Changde, Hunan, 415003, China.
BMC Infect Dis. 2025 Apr 8;25(1):478. doi: 10.1186/s12879-025-10884-9.
Invasive Cerebral Aspergillosis (ICA) is a rare fungal infection affecting the brain, primarily seen in individuals with compromised immune systems. Despite various treatment options, substantial cerebral granulomas caused by ICA still result in high mortality and recurrence rates.
We report a rare instance of ICA in a 30-year-old pregnant woman. The infection initiated in the nasal cavity and progressed to form a large intracranial granuloma, leading to brain herniation. Diagnosis was confirmed through histopathology, Polymerase Chain Reaction (PCR), and metagenomic next-generation sequencing (mNGS) following decompressive craniotomy and sinus window drainage surgery. Prompt administration of antifungal medication resulted in a favorable prognosis.
This case highlights the critical roles of mNGS and PCR in the early diagnosis of ICA, as well as the pivotal importance of surgical interventions and prompt initiation of antifungal therapy in enhancing patient outcomes.
侵袭性脑曲霉病(ICA)是一种罕见的脑部真菌感染,主要见于免疫系统受损的个体。尽管有多种治疗选择,但由ICA引起的大量脑肉芽肿仍导致高死亡率和复发率。
我们报告了一例30岁孕妇罕见的ICA病例。感染始于鼻腔,进展为形成一个大的颅内肉芽肿,导致脑疝。在减压开颅术和鼻窦开窗引流手术后,通过组织病理学、聚合酶链反应(PCR)和宏基因组下一代测序(mNGS)确诊。及时给予抗真菌药物治疗,预后良好。
本病例突出了mNGS和PCR在ICA早期诊断中的关键作用,以及手术干预和及时启动抗真菌治疗对改善患者预后的至关重要性。