Intracranial Aspergillus Granuloma

C Sundaram,J M K Murthy

doi:10.4061/2011/157320

Abstract

Intracranial fungal granulomas are rare and of the histologically verified granulomas, Aspergillus spp. is the commonest causative fungal pathogen. Most of the reported large series of aspergillus granulomas are from countries with temperate climate like India, Pakistan, Sudan, and Saudi Arabia. In contrast to disseminated aspergillosis that occurs in immunosuppressed individuals, most of the intracranial aspergillus granulomas are reported in immunocompetent individuals. The temperature, humidity, high spore content in the atmosphere during ploughing, and occupation as agricultural worker are implicated in the pathogenesis. The sinocranial spread is the most common route of intracranial extension. Extracerebral firm fibrotic lesions and skull base lesions are common. Extensive fibrosis and large number of multinucleated giant cells are the characteristic histological features and these pathological features have therapeutic relevance.

Highlights

Fungal infections of the central nervous system (CNS) are more frequently reported in the last few decades mostly due to increase in the population at risk, increased awareness, and better diagnostic modalities [1,2,3,4]
The fungi may involve any part of the neuroaxis, and the pathology includes meningitis, encephalitis, abscess, granuloma, and vasculitis with associated infarction and hemorrhage and aneurysmal formation [1,2,3,4, 13]
This paper will discuss the experience with intracranial Aspergillus granuloma

Summary

Introduction

Fungal infections of the central nervous system (CNS) are more frequently reported in the last few decades mostly due to increase in the population at risk, increased awareness, and better diagnostic modalities [1,2,3,4]. The fungi enter the CNS by hematogenous route from the systemic focus, or by contiguous spread from paranasal sinuses (PNS), ear or skull bone; or by direct inoculation during trauma or surgical procedure [1,2,3,4,5]. The pathology depends upon the route of spread, host immunity, and type of fungus, hyphae, or yeast. The fungi may involve any part of the neuroaxis, and the pathology includes meningitis, encephalitis, abscess, granuloma, and vasculitis with associated infarction and hemorrhage and aneurysmal formation [1,2,3,4, 13]. This paper will discuss the experience with intracranial Aspergillus granuloma

Epidemiology

Pathogenesis

Pathology

Findings

Sinocranial Aspergillus Granuloma—Pathological Features—Therapeutic Relevance