Cerebral Aspergillosis in an Immunocompetent Patient after COVID-19 Infection / Aspergilose Cerebral em Paciente Imunocompetente após Infecção por COVID-19

Fungal brain abscesses are an uncommon condition in the immunocompetent population, especially due to the etiologic agent Aspergillus sp. The emerging coronavirus disease 2019 (COVID-19) pandemic brought about neurological manifestations that were previously little known, caused by the direct manifestations of the virus, as well as by the therapy itself, with hospitalization and use of corticosteroids. This manuscript highlights the need for attention in the management of patients with neurological disorders and history of COVID-19 infection. In the current paper, we report the case of a patient without comorbidities who presented multiple brain abscesses caused by Aspergillus fumigatus, after infection by Severe Acute Respiratory Syndrome Coronavírus 2 (SARS-CoV-2).

Abscessos cerebrais fúngicos são uma condição incomum na população imunocompetente, especialmente quando provocada pelo agente etiológico Aspergillus sp. A epidemia emergente do novo coronavírus (COVID-19) trouxe acometimentos neurológicos até então pouco conhecidos, ocasionados pelas manifestações diretas do vírus, como também pela própria terapia, com internação e uso de corticoesteróides. Este manuscrito destaca a necessidade de atenção no manejo de pacientes com alterações neurológicas e história de infecção pelo vírus. No presente trabalho, relatamos o caso de um paciente sem comorbidades que apresentava múltiplos abscessos cerebrais causados por Aspergillus fumigatus, após infecção pelo SARS-CoV-2.

Invasive pulmonary aspergillosis with brain dissemination in an immunocompetent host.

Invasive aspergillosis is an uncommon infection, which is mainly seen among immunocompromised patients. In recent years, cases of aspergillosis involving immunocompetent hosts are increasingly being reported. Herein, we report the case of a 27-year-old man with fever, productive cough, shortness of breath, and left hemiparesis. He had suffered trauma to his head 25 days prior. Imaging of the chest showed bilateral cavitary lesions in the lungs, and neuroimaging revealed a space-occupying lesion in the right frontoparietal cerebrum. He was suspected of having an abscess or metastasis. He died on day 3 of hospitalization, and an autopsy was performed. The autopsy revealed the cause of death to be invasive pulmonary aspergillosis, with brain dissemination. Invasive aspergillosis is uncommon in apparently immunocompetent individuals, and we discuss the autopsy findings in detail.

Invasive pulmonary aspergillosis with brain dissemination in an immunocompetent host

Invasive aspergillosis is an uncommon infection, which is mainly seen among immunocompromised patients. In recent years, cases of aspergillosis involving immunocompetent hosts are increasingly being reported. Herein, we report the case of a 27-year-old man with fever, productive cough, shortness of breath, and left hemiparesis. He had suffered trauma to his head 25 days prior. Imaging of the chest showed bilateral cavitary lesions in the lungs, and neuroimaging revealed a space-occupying lesion in the right frontoparietal cerebrum. He was suspected of having an abscess or metastasis. He died on day 3 of hospitalization, and an autopsy was performed. The autopsy revealed the cause of death to be invasive pulmonary aspergillosis, with brain dissemination. Invasive aspergillosis is uncommon in apparently immunocompetent individuals, and we discuss the autopsy findings in detail.

Aspergilosis cerebral en un paciente postrasplante cardiaco: reporte de caso / Brain Aspergilosis after Cardiac Transplant: Case Report

RESUMEN Los pacientes trasplantados son susceptibles a complicaciones neurológicas derivadas entre otros aspectos, de las complicaciones mismas del procedimiento, el cuidado crítico que requieren los pacientes, y de los efectos secundarios a los medicamentos utilizados y el efecto inmunoderpresor de los mismos. Este último hace que los pacientes estén expuestos a infecciones oportunistas. Dentro de estas, las Infecciones del Sistema Nervioso Central en el paciente trasplantado constituyen un reto diagnóstico. Dentro de los procesos infecciosos es importante tener en cuenta aquellos relacionados con hongos, especialmente en los 3 primeros meses posterior al trasplante. Se presenta el caso de un paciente 67 años con antecedente de trasplante cardíaco, quien ingresa con un proceso febril y posterior compromiso neurológico.

SUMMARY Transplanted patients are susceptible to neurological complications arising, among other things, from the complications of the procedure itself, the critical care, and the side effects to the medications used and the immunodepressive effect thereof. It's causes patients to be exposed to opportunistic infections. Within these, Central Nervous System Infections in the transplanted patient constitute a diagnostic challenge. Within infectious processes it is important to take into account those related to fungi, especially in the first 3 months after transplantation. We present the case of a 67 years old patient with a history of heart transplantation, which enters with a febrile process and subsequent neurological compromise.