Posaconazole responsive cerebral aspergillosis in an immunocompetent adult

• Published in: Journal of clinical neuroscience Vol. 21; no. 10; pp. 1825 - 1827
• Main Authors: Ellenbogen, Jonathan Richard, Waqar, Mueez, Denning, David W, Cooke, Richard P.D, Skinner, Derek W, Lesser, Tristram, Javadpour, Mohsen
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01-10-2014
• Subjects: Aged; Antifungal Agents - therapeutic use; Aspergillosis; Aspergillosis - drug therapy; Aspergillosis - pathology; Aspergillosis - surgery; Brain - drug effects; Brain - pathology; Brain - surgery; Central nervous system; Encephalitis - drug therapy; Encephalitis - pathology; Encephalitis - surgery; Humans; Immunocompetent; Magnetic Resonance Imaging; Male; Neurology; Posaconazole; Suction; Treatment Outcome; Triazoles - therapeutic use; Voriconazole; Voriconazole - therapeutic use; Immunocompetent; Posaconazole; Aspergillosis; Central nervous system; Voriconazole
• ISSN: 0967-5868; 1532-2653
• DOI: 10.1016/j.jocn.2014.05.004

Abstract Cerebral aspergillosis is a rare manifestation of invasive aspergillosis that usually affects immunocompromised patients. There are few treatment options for recurrent disease and experiences with immunocompetent patients are lacking. We report the clinical course of an immunocompetent patient with recurrent cerebral aspergillosis, following initial treatment with burr hole aspiration and voriconazole, who showed remarkable response to posaconazole. The patient remains clinically well with no evidence of recurrence on MRI 7 years following diagnosis. To our knowledge this is the first reported experience with posaconazole in an immunocompetent patient with cerebral aspergillosis.