Case Report: Rare invasive aspergillosis with brain abscess in a non–classically immunosuppressed patient, and pooled analysis of individual patient data (2000–2024)
Year: 2025
Type: article
Abstract: Intracranial aspergillosis is uncommon but often lethal, especially in classically immunocompromised hosts. We report a 71-year-old man with poorly controlled diabetes (a non-classical risk factor) who developed bilateral frontal abscesses due to Aspergillus fumigatus . After an initial craniotomy with negative cultures and galactomannan, recurrent disease was confirmed by stereotactic biopsy with next-generation sequencing (NGS). Targeted azole therapy (voriconazole, isavuconazole) and multidisciplinary care led to marked clinical and radiographic improvement. We also pooled 343 published cases (2000–2024): overall mortality was 34.6%, and 21.8% among patients without classical immunosuppression (including some with non-classical factors such as diabetes). Improved survival in recent decades likely reflects earlier diagnosis and broader azole use, though inference is limited by case-based evidence. Early tissue diagnosis (including molecular testing), timely surgery when indicated, and CNS-penetrant azoles can yield favorable outcomes in non-classically immunosuppressed patients.
Source: Frontiers in Surgery
Authors: Moksada Regmi, Shikun Liu, Yuwei Dai, Jingyi Ye, Xiaodong Chen, Jun Yang, Chenlong Yang
Institutions: Peking University, Peking University Third Hospital
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
Awards: G5709143055, G7581136438, G8469532368
OpenAlex ID: W4415462058