Central nervous system aspergillosis caused by Aspergillus niger after implant cranioplasty in an immunocompetent patient: a case report
Year: 2026
Type: preprint
Study design: Case Report
Abstract: Background : Central nervous system aspergillosis (CA) is predominantly seen in immunosuppressed individuals and is associated with poor outcomes. This report describes a rare case of implant associated CA caused by Aspergillus niger in an immunocompetent patient following neurosurgery. Case presentation : A 61-year-old immunocompetent male presented with wound discharge and neurological deficit three years after neurosurgery for a ruptured anterior communicating artery aneurysm. Subsequent surgical interventions included autologous bone and implant cranioplasties. The patient developed a postoperative infection characterized by headache, hemiparesis, and wound discharge. Imaging revealed a peripherally enhancing lesion, and intraoperative findings raised suspicion of fungal infection. Microbiological studies confirmed Aspergillus niger . The patient was managed with surgical debridement, implant removal, and targeted antifungal therapy with voriconazole, with careful monitoring of drug levels. Clinical improvement was observed, and reconstructive cranioplasty was successfully performed after six weeks of antifungal therapy. Conclusion : CA due to Aspergillus niger is exceedingly rare in immunocompetent hosts and may occur post-neurosurgery via contiguous spread from the paranasal sinuses. Early recognition combined surgical and antifungal management, and therapeutic drug monitoring are crucial for optimal outcomes.
Source: Research Square
Institution: Aditya Birla Memorial Hospital
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7204179623