Aspergillosis following Neurosurgery

Submitted by: Michael on: 16 April 2013

Case number: 50

Summary:

A 16 year-old girl was submitted to neurosurgery for Chiari I malformation and received a prolonged corticosteroid regimen. Severe headache persisted 3 weeks after surgery, when cerebrospinal fluid cultures grew a few colonies of A. fumigatus. This was felt to be a culture contaminant. She continued to have severe headaches, and a wound exploration revealed that sutures had dehisced. Cultures again revealed A. fumigatus , and amphotericin B was started. Repeated surgical interventions were required, and the dural graft was eventually removed.
She died 2 months after the first surgical procedure. Autopsy studies revealed abundant hyphae in the origin of the basilar artery and bilateral vertebral arteries, with multifocal transmural destruction of arterial walls. No other focus of aspergillosis was found.

Keywords: aspergillosis, sinus, chiara 1, neorosurgery,

Species (if applicable): Aspergillus fumigatus

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