Aspergillus meningitis: A rare clinical manifestation of central nervous system aspergillosis. Case report and review of 92 cases

Spinello Antinori, Mario Corbellino, Luca Meroni, Federico Resta, Salvatore Sollima, Massimo Tonolini, Anna Maria Tortorano, Laura Milazzo, Lorenzo Bello, Elisa Furfaro, Massimo Galli, Claudio Viscoli

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To describe the pathogenesis, clinical presentation, cerebrospinal fluid findings and outcome of Aspergillus meningitis, meningoencephalitis and arachnoiditis. Methods: A case of Aspergillus meningitis is described. A comprehensive review of the English-language literature was conducted to identify all reported cases of Aspergillus meningitis described between January 1973 and December 2011. Results: Ninety-three cases (including the one described herein) of Aspergillus meningitis were identified. Fifty-two (55.9%) were in individuals without any predisposing factor or known causes of immunosuppression. Acute and chronic meningitis was diagnosed in 65.6% of patients and meningoencephalitis in 24.7% of them with the remaining presenting with spinal arachnoiditis and ventriculitis. Cerebrospinal fluid cultures for Aspergillus spp. were positive in about 31% of cases and the galactomannan antigen test in 87%. Diagnosis during life was achieved in 52 patients (55.9%) with a case fatality rate of 50%. The overall case fatality rate was 72.1%. Conclusions: Aspergillus meningitis may occur in both immunocompetent and immunocompromised patients and run an acute or chronic course. The findings of this systematic review extend the information on this life-threatening infection and could assist physicians in achieving an improved outcome.

Original languageEnglish
Pages (from-to)218-238
Number of pages21
JournalJournal of Infection
Volume66
Issue number3
DOIs
Publication statusPublished - Mar 2013

Keywords

  • Aspergillus meningitis
  • Diagnosis
  • Galactomannan antigen
  • Therapy

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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