Cerebral Aspergilloma Mimicking Brain Tumor as Challenge for Neurocritical Care Medicine: A Case Report

Cerebral aspergillosis is a rare but potentially deadly fungal infection that may require surgical treatment in some cases. Most commonly, this infection occurs in patients with compromised immune systems, such as those with cancer, HIV/AIDS, organ transplants, or steroid therapy. We reported a 60-year-old male with right parieto-occipital predominance, objective vertigo with horizontal rotational nystagmus, syncope episodes with position changes, and ataxia, who performed a brain MRI which showed a left frontoparietal contrast-enhancing lesion with a slight midline shift mimicking a brain tumor. However, after surgical resection, microscopic examination revealed extensive Aspergillus fumigatus presence. Targeted antibiotic therapy has been started. Early antifungal therapy helps with the treatment though the final diagnosis requires pathological examination and cultures of the drainage of the brain abscess. The prognosis is relatively good if treated early and there are no major complications. Aspergillus brain infection should be considered when concurrent dental or pulmonary infection. Early antifungal therapy helps with the treatment though the final diagnosis requires pathological examination and cultures of the drainage of the brain abscess.