Early diagnosis of central nervous system aspergillosis with combination use of cerebral diffusion-weighted echo-planar magnetic resonance image and polymerase chain reaction of cerebrospinal fluid

Intern Med. 1999 Jan;38(1):45-8. doi: 10.2169/internalmedicine.38.45.

Abstract

We treated a patient diagnosed as central nervous system (CNS) aspergillosis with the combined use of cerebral diffusion-weighted echo-planar magnetic resonance imaging (DWI) and polymerase chain reaction of the cerebrospinal fluid (CSF-PCR). DWI, a cutting-edge imaging modality to reveal the earliest changes of cerebral infarction, detected cerebral fungal embolization when the conventional computed tomographic scan and magnetic resonance imaging failed to reveal it. CSF-PCR demonstrated the presence of Aspergillus-specific DNA in the specimen, when the conventional examination and culture of CSF were nonspecific or negative. These diagnostic methods could be useful in the early diagnosis of CNS aspergillosis.

Publication types

  • Case Reports

MeSH terms

  • Aspergillosis / cerebrospinal fluid
  • Aspergillosis / diagnosis*
  • Aspergillosis / microbiology
  • Aspergillus fumigatus / genetics*
  • Aspergillus fumigatus / isolation & purification
  • Brain / microbiology
  • Brain / pathology*
  • Cerebral Infarction / cerebrospinal fluid
  • Cerebral Infarction / diagnosis*
  • Cerebral Infarction / microbiology
  • Cerebrospinal Fluid / microbiology*
  • DNA, Fungal / analysis
  • Echo-Planar Imaging*
  • Fatal Outcome
  • Humans
  • Male
  • Middle Aged
  • Polymerase Chain Reaction

Substances

  • DNA, Fungal