Thoracic spinal cord intramedullary aspergillus invasion and abscess

Addason F. McCaslin, Rishi Rajiv Lall, Albert P. Wong, Rohan R. Lall, Patrick A. Sugrue, Tyler R. Koski

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Invasive central nervous system aspergillosis is a rare form of fungal infection that presents most commonly in immunocompromised individuals. There have been multiple previous reports of aspergillus vertebral osteomyelitis and spinal epidural aspergillus abscess; however to our knowledge there are no reports of intramedullary aspergillus infection. We present a 19-year-old woman with active acute lymphoblastic leukemia who presented with several weeks of fevers and bilateral lower extremity weakness. She was found to have an intramedullary aspergillus abscess at T12-L1 resulting from adjacent vertebral osteomyelitis and underwent surgical debridement with ultra-sound guided aspiration and aggressive intravenous voriconazole therapy. To our knowledge this is the first reported case of spinal aspergillosis invading the intramedullary cavity. Though rare, this entity should be included in the differential for immunocompromised patients presenting with fevers and neurologic deficit. Early recognition with aggressive neurosurgical intervention and antifungal therapy may improve outcomes in future cases.

Original languageEnglish (US)
Pages (from-to)404-406
Number of pages3
JournalJournal of Clinical Neuroscience
Volume22
Issue number2
DOIs
StatePublished - Feb 1 2015
Externally publishedYes

Keywords

  • Abscess
  • Central nervous system vasculitis
  • Fungi
  • Intramedullary aspergilloma
  • Neuroaspergillosis
  • Precursor cell lymphoblastic leukemia-lymphoma

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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