Title: Cerebral aspergillosis in adult critically ill patients: a descriptive report of 10 patients from the AspICU cohort
Authors: Spapen, Herbert ×
Spapen, Jerrold
Taccone, Fabio S
Meersseman, Wouter
Rello, Jordi
Dimopoulos, George
Charles, Pierre-Emmanuel
Rao, Ratna
Pérez, Marcos
Martin, Claude
Vogelaers, Dirk
Blot, Stijn I
the AspICU Study Investigators #
Issue Date: Feb-2014
Publisher: Elsevier Science Publishers
Series Title: International Journal of Antimicrobial Agents vol:43 issue:2 pages:165-9
Article number: S0924-8579(13)00369-5
Abstract: An unexpectedly high incidence of invasive pulmonary aspergillosis (IPA) has been reported in non-neutropenic intensive care unit (ICU) patients. After the respiratory tract, the brain is most often affected by invasive aspergillosis. However, little is known about brain involvement by Aspergillus in critically ill patients. In this study, demographics, risk profile, diagnosis, treatment and outcome of proven cases of invasive cerebral aspergillosis (ICA) taken from a cohort of 563 adult patients with evidenced Aspergillus involvement during their ICU stay were reviewed. Ten patients with central nervous system aspergillosis were identified. All had one or more host factors predisposing for invasive aspergillosis. The clinical and radiological presentation was non-specific and exclusively pulmonary-related. All but one patient had proven or probable/putative IPA. On cerebral computed tomography, lesions appeared as either solitary and hyperdense or were multiple and randomly distributed throughout the brain. One patient presented with sole meningeal infestation. Aspergillus infection was confirmed by brain biopsy in three subjects. Voriconazole was used as primary treatment in only one-half of the patients. Mortality was 90%. ICA is not frequently observed in adult ICU patients. Diagnosis must be considered in patients at risk presenting with proven or probable/putative IPA in association with suggestive neuroradiological findings. The brain is most likely affected through haematogenous dissemination from the lungs. Current treatment recommendations are not always applied and outcome remains dismal.
ISSN: 0924-8579
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory for Clinical Infectious and Inflammatory Disorders
× corresponding author
# (joint) last author

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