Two Cases of Cerebral Aspergillosis Originated from Sphenoid Sinus / 대한이비인후과학회지

ABSTRACT

Sphenoid aspergillosis is unusual and more aggressive than other paranasal aspergillosis. Intacranial extension of sphenoid aspergillosis may occur via direct spread of invasive disease or along communicating veins despite intact sinus walls. This tends to occur in immunocompromised patients and once this occurs, mortality is high. Recently, itraconazole, a triazole derivatives with a broad antifungal spectrum, is used instead of conventional antifungal agent. We experienced two cases of cerebral aspergillosis, both of which originated from the sphenoid sinus. Of these cases, one resulted in complete resolution through therapy with high dose itraconazole after endoscorpic sinus surgery but the other one case failed to keep up with the high dose itraconazole therapy and was lost in follow-up because of side effects of drug. So, we report the important role and side effects of high dose itraconazole against cerebral aspergillosis with a review of the literature.