RESUMO
A case of disseminated aspergillosis [IA] with cerebral involvement is reported in a Tunisian 57-year-old patient suffering from acute lymphoblastic leukemia. Respiratory symptoms including hemoptysis appeared the fortieth day after initiation of an anti-leukemia treatment. Three days later, the patient developed seizures and left-sided hemiparesis together with an ictera. Chest X-ray, CT and MRI were evocative of disseminated IA with pulmonary, cerebral, maxillary sinus and likely hepatic involvement. Aspergillus niger was isolated from suptum in four occasions, and the antigenemia was positive. The patient was treated with amphotericin B, then with voriconazole and underwent a surgical drainage of his cerebral abcess. The outcome was favourable without any clinical relapse 2 years later and the patient has remained in haematological remission. But, the patient ultimately died of a leukemia relapse on December 10 [th], 2009