{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T23:52:16Z","timestamp":1794268336339,"version":"4.9.0"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T00:00:00Z","timestamp":1582502400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T00:00:00Z","timestamp":1582502400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In patients at high risk of opportunistic infections who present with isolated.<\/jats:p>\n                <jats:p>neurological symptoms, it is lifesaving to consider Central Nervous System Aspergillosis (CNS-A). Ibrutinib use in chronic lymphocytic leukemia (CLL) has previously been associated with CNS-A. We provide a case report of a patient that presented with primary CNS-A on Ibrutinib therapy without any prior pulmonary or local paranasal signs of infection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>74-year-old Caucasian male with CLL and no prior chemotherapy on ibrutinib for 6\u2009months presented with three months of unsteady gait, occipital headache, and confusion. He has a history of pulmonary sarcoidosis on chronic prednisone 5\u2009mg daily and chronic obstructive pulmonary disease (COPD). He was found to have a \u201cbrain abscess\u201d on imaging. Emergent craniotomy confirmed Aspergillus and patient was treated with Voriconazole for 6\u2009months. At six-month follow up, repeat magnetic resonance imaging (MRI) confirmed complete resolution of CNS lesion.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our case reinforces the importance of being vigilant for isolated CNS-A in CLL patients on ibrutinib who present with neurological symptoms and signs, without prior or co-infection of sino-pulmonary tissue.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-020-4894-2","type":"journal-article","created":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T16:09:09Z","timestamp":1582560549000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Isolated central nervous system Aspergillosis infection in a chronic lymphocytic leukemia patient on Ibrutinib: A case report"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2460-7769","authenticated-orcid":false,"given":"Thuy-Hong","family":"Le","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khubaib","family":"Gondal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Barnes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haseeb","family":"Siddique","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barjinder","family":"Buttar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Kaell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,2,24]]},"reference":[{"key":"4894_CR1","unstructured":"About Aspergillosis. Centers for Disease Control and Prevention. 2019. https:\/\/www.cdc.gov\/fungal\/diseases\/aspergillosis\/definition.html."},{"key":"4894_CR2","first-page":"1593","volume":"374","author":"J Sharman","year":"2016","unstructured":"Sharman J. Ibrutinib for chronic lymphocytic leukemia: NEJM. N Engl J Med. 2016;374:1593\u20134.","journal-title":"N Engl J Med"},{"key":"4894_CR3","first-page":"3","volume":"1","author":"J Peter Donnelly","year":"2019","unstructured":"Peter Donnelly J, Chen SC, Kauffman CA, et al. Revision and update of the consensus definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer and the mycoses study group education and research consortium. Clin Infect Dis. 2019;1:3\u20136.","journal-title":"Clin Infect Dis"},{"key":"4894_CR4","first-page":"S37","volume":"51","author":"T Nadkarni","year":"2005","unstructured":"Nadkarni T, Goel A. Aspergilloma of the brain: an overview. J Postgrad Med. 2005;51:S37\u201341.","journal-title":"J Postgrad Med"},{"key":"4894_CR5","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1093\/cid\/ciw444","volume":"63","author":"TF Patterson","year":"2016","unstructured":"Patterson TF, Thompson GR, et al. Practice guidelines for the diagnosis and Management of Aspergillosis: 2016 update by the infectious diseases society of America. Clin Infect Dis. 2016;63:32\u201350.","journal-title":"Clin Infect Dis"},{"key":"4894_CR6","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1097\/MD.0b013e318274cd77","volume":"91","author":"TK Kourkoumpetis","year":"2012","unstructured":"Kourkoumpetis TK, et al. Central nervous system Aspergillosis: A series of 14 cases from a general hospital and review of 123 cases from the literature. Medicine. 2012;91:328\u201336.","journal-title":"Medicine"},{"key":"4894_CR7","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1111\/j.1469-0691.1999.tb00438.x","volume":"5","author":"A Payot","year":"1999","unstructured":"Payot A. Primary central nervous system Aspergillosis: a case report and review of the literature. Clinical Microbiology and Infection, ESCMID. 1999;5:573\u20136.","journal-title":"Clinical Microbiology and Infection, ESCMID"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-020-4894-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12879-020-4894-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-020-4894-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T00:11:08Z","timestamp":1614039068000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-020-4894-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,24]]},"references-count":7,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["4894"],"URL":"https:\/\/doi.org\/10.1186\/s12879-020-4894-2","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,24]]},"assertion":[{"value":"24 November 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 February 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 February 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The patient in this case report gave written consent for their clinical details along with any identifying images to be published in this study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors listed above have no relations with industry or any conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"175"}}