Invasive sinus aspergillosis with mycotic aneurysm of the vertebral artery and subarachnoid hemorrhage : case report

Mencinger, Maruša (author), Matos, Tadeja (author), Šurlan Popović, Katarina (author)

Invasive sinus aspergillosis is a rare life-threatening condition usually found in immunocompromised patients. The fungus spreads from paranasal sinuses into the central nervous system by direct extension or through blood vessels. Perineural spread is an uncommon mechanism of spread in invasive aspergillosis. A mycotic aneurysm is a dangerous complication of invasive sinus aspergillosis because of its insidious development and is often diagnosed only post-mortem after causing fatal intracranial hemorrhage. Intracranial vascular complications of invasive sinus aspergillosis require prompt recognition and treatment and should always be considered when a diagnosis of CNS aspergillosis is made. We present a case of invasive sinus aspergillosis in an apparently immunocompetent patient that manifested with a brain abscess, perineural spread of the infection, and mycotic aneurysm of the vertebral artery with subsequent rupture and fatal subarachnoid hemorrhage. This case highlights the possibility of perineural spread and hemorrhagic complications in invasive cerebral aspergillosis.

• Language: English
• Keywords: aspergillosis, sinusitis, invasive sinus aspergillosis, mycotic aneurysm, perineural spread, subarachnoid hemorrhage
• Work type: Article
• Typology: 1.03 - Other scientific articles
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2021
• Number of pages: Str. 2651-2657
• Numbering: Vol. 16, iss. 9
• PID: 20.500.12556/RUL-138710
• UDC: 616
• ISSN on article: 1930-0433
• DOI: 10.1016/j.radcr.2021.06.041
• COBISS.SI-ID: 71115267
• Publication date in RUL: 10.08.2022

Record is a part of a journal

• Title: Radiology case reports
• Publisher: Elsevier, University of Washington
• ISSN: 1930-0433
• COBISS.SI-ID: 523758361

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Keywords: aspergiloza, sinuzitis, invazivna aspergiloza sinusov, mikotična anevrizma, subarahnoidna krvavitev