Silent Fungal Invasion: A Case of Aspergillus Brain Abscesses in an Immunocompetent Older Adult Patient

TL;DR

An 84-year-old man with no immune issues developed rare fungal brain abscesses caused by Aspergillus, showing the need to consider such infections in older adults with brain lesions.

Contribution

This case report highlights the rare occurrence of Aspergillus brain abscesses in an immunocompetent elderly patient.

Findings

An 84-year-old immunocompetent man developed multiple Aspergillus brain abscesses.

Fungal infection was confirmed through cultures from surgical samples.

The patient's neurological condition worsened despite antifungal treatment.

Abstract

Brain abscesses caused by fungal pathogens are uncommon in immunocompetent individuals. An 84-year-old man presented with fever and headache. Brain imaging identified a nonspecific right frontal lesion. He returned with worsening symptoms and confusion after two weeks, with magnetic resonance imaging (MRI) revealing multiple abscesses with ring enhancement. Cultures from surgical resection and drainage samples grew Aspergillus. Despite antifungal therapy, his neurological condition declined. This case highlights the importance of considering fungal pathogens in older patients with nonspecific brain lesions, even without focal neurological symptoms or evidence of a primary infection.

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