{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T02:40:04Z","timestamp":1722998404522},"reference-count":27,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\"><jats:title>Background:<\/jats:title><jats:p>Central nervous system involvement due to aspergillosis is an extremely serious entity, particularly in patients with severe neutropenia, hematological diseases, or post-transplant cases. Immunocompetent patients can be infected by intense exposure, particularly iatrogenic after invasive procedures.<\/jats:p><\/jats:sec><jats:sec id=\"st2\"><jats:title>Case Description:<\/jats:title><jats:p>We present the case of a 26-year-old male with a 1 year appendectomy background, which required epidural anesthesia. After that surgery, insidious headache presented, requiring mild analgesics for adequate control. In the following weeks, headaches increased and tomographic imaging revealed hydrocephalus. A ventriculoperitoneal shunt was placed, and empirical treatment for neurocysticercosis was established, but diagnosis was never confirmed. Sequentially, shunt dysfunction occurred twice, for which shunt replacement was performed. Cerebrospinal fluid and shunt\u2019s catheter were cultured. Some days later, a filamentous fungus was isolated and finally identified as<jats:italic>Aspergillus<\/jats:italic>sp. Intravenous amphotericin B and fluconazole at therapeutic dosage were administered; however, a torpid clinical evolution was observed. After a 2-week antifungal scheme, the fungus was identified as<jats:italic>Aspergillus terreus<\/jats:italic>. The patient developed sudden rostrocaudal deterioration. Computed tomography imaging was done, revealing a 70 cc hematoma in the right operculoinsular region, midline shift, and a 9 mm saccular aneurysm at the bifurcation of the middle cerebral artery.<\/jats:p><\/jats:sec><jats:sec id=\"st3\"><jats:title>Conclusion:<\/jats:title><jats:p>Cerebral aspergillosis is a serious disease with high mortality in patients, particularly those without identifiable risk factors. The iatrogenic forms are serious, due to the delay of clinical diagnosis. It is important to have a high index of suspicion in patients with a history of invasive procedures such as epidural anesthesia or surgery, and who develop a persistent chronic headache or chronic meningitis.<\/jats:p><\/jats:sec>","DOI":"10.25259\/sni_506_2019","type":"journal-article","created":{"date-parts":[[2020,6,6]],"date-time":"2020-06-06T05:41:58Z","timestamp":1591422118000},"page":"139","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Fungal mycotic aneurysm in a patient with<i>Aspergillus terreus<\/i>chronic meningoencephalitis"],"prefix":"10.25259","volume":"11","author":[{"given":"Marcos Vinicius","family":"Sangrador-Deitos","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jimena Alejandra Gonz\u00e1lez","family":"Olvera","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Instituto Mexicano del Seguro Social, Le\u00f3n, Mexico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidy Adames","family":"Espinal","sequence":"additional","affiliation":[{"name":"Departments of Neuroinfectology, National Institute of Neurology and Neurosurgery, Mexico,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graciela C\u00e1rdenas","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Departments of Neuroinfectology, National Institute of Neurology and Neurosurgery, Mexico,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ver\u00f3nica Angeles","family":"Morales","sequence":"additional","affiliation":[{"name":"Departments of Neuroinfectology, National Institute of Neurology and Neurosurgery, Mexico,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Luis","family":"Soto Hernandez","sequence":"additional","affiliation":[{"name":"Departments of Neuroinfectology, National Institute of Neurology and Neurosurgery, Mexico,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2020,6,6]]},"reference":[{"key":"10.25259\/SNI_506_2019\/ref-1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.3171\/jns.1978.49.1.0107","article-title":"Cerebral mycotic aneurysm of fungal origin. 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