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Lack of efficacy: case report A 74-year-old woman exhibited lack of efficacy during treatment with amphotericin-B and voriconazole for intracranial aspergillosis [routes and dosages not stated]. The woman admitted with altered mental status, seizures and tendency to sleep. A week earlier, she was hospitalised with hyponatraemia and nephrotic syndrome. She was treated with unspecified steroids. Cranial MRI showed peripheral contrast enhancing lesions and parenchymal oedema in the left parietal lobe, insular cortex, putamen and right superior frontal gyrus, frontal lobe and precentral gyrus. Initially, metastatic brain tumour was considered and brain biopsy was performed. The histopathologic examination was compatible with aspergillus infection. Abdominal and thoracic CT scans, and echocardiography findings showed bilateral pleural and pericardial effusion, diffuse subcutaneous oedema and free fluid in the abdomen. She tested positive for SS-A and Ro-52. She started receiving treatment amphotericin-B followed by voriconazole. Consequently, brain oedema diminished and cranial lesions disappeared. Despite this antifungal treatment, she died at the 4th month of hospitalisation. Nalbantoglu M, et al. Intracranial Aspergillosis presenting with multiple cerebral abscesses: A case report. European Journal of Neurology 27 (Suppl. 1): 1183 (plus poster) 803498395 abstr. EPO3277, May 2020. Available from: URL: https://doi.org/10.1111/ene.14308 [abstract]

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Reactions 29 Aug 2020 No. 1819