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.

Aspergillus meningitis : a rare clinical manifestation of central nervous system aspergillosis : case report and review of 92 cases / S. Antinori, M. Corbellino, L. Meroni, F. Resta, S. Sollima, M. Tonolini, A.M. Tortorano, L. Milazzo, L. Bello, E. Furfaro, M. Galli, C. Viscoli. - In: JOURNAL OF INFECTION. - ISSN 0163-4453. - 66:3(2013 Mar), pp. 218-238. [10.1016/j.jinf.2012.11.003]

Aspergillus meningitis : a rare clinical manifestation of central nervous system aspergillosis : case report and review of 92 cases

S. Antinori
Primo
;
A.M. Tortorano;L. Bello;M. Galli
Penultimo
;
2013

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.
Aspergillus meningitis; Diagnosis; Galactomannan antigen; Therapy
Settore MED/42 - Igiene Generale e Applicata
Settore MED/17 - Malattie Infettive
mar-2013
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/219557
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