PULMONARY ASPERGILLOSIS WITH HEMATOLOGIC DISSEMINATION TO THE CENTRAL NERVOUS SYSTEM: CASE REPORT

• DOI: https://doi.org/10.22533/at.ed.1595102511027

• Palavras-chave: Aspergillosis; Pulmonary Aspergillosis; Central Nervous System; Neuroaspergillosis.

• Keywords: Aspergillosis; Pulmonary Aspergillosis; Central Nervous System; Neuroaspergillosis.

• Abstract:

  Aspergillosis is an opportunistic infectious disease that affects the lower respiratory tract through the inhalation of spores of the fungus genus Aspergillus, most commonly by individuals with reduced immunity. With this in mind, the aim of this study is to describe a case report of an adult patient diagnosed with pulmonary aspergillosis that evolved into a hematogenously disseminated disease with central nervous system involvement. The patient was 65 years old, female, with a history of severe osteoarthritis of the right and left knees, taking corticosteroids and suffering from prosthetic infection. She had undergone bilateral arthroplasty and had negative general cultures. During hospitalization, the patient developed a high fever with no focus and no response to conventional antibiotic therapy, and was referred to an infectious disease specialist. A laboratory test for the enzyme galactomannan was carried out, with a positive result, and together with the CT scan findings, the hypothesis of pulmonary aspergillosis was raised. Variconazole was started, but other complications followed with asystole and death. However, the diagnosis of invasive aspergillosis is difficult due to the lack of a test with high specificity and the absence of a pathognomonic sign/symptom. However, it is essential to determine a rapid and effective diagnosis to ensure better recovery and patient survival.