Case Report

Aspergillus fumigatus Epidural Abscess and Postsurgical Wound Infection in an Immunocompetent Host

Table 1

Literature review of Aspergillus fumigatus associated with postsurgical wound or abscess in immunocompetent patients.

ReferenceAge/sexSurgery performedInterval between surgery and infectionInfectious complicationMethod of diagnosisGM statusAntifungal treatmentOutcome

Index case54/FNeurosurgery/suboccipital craniectomy with C1 laminectomy and duraplasty3 weeksWound site infection with seroma and epidural abscess with meningitisSurgical excision, cultureNegativeVoriconazole (loading dose then 350 mg twice a day) for approximately 5 monthsAlive. Resolution of epidural abscess
Chen et al. [9]46/FMastoidectomy/craniectomies/chronic otitis mediaApprox. 2 years and 5 monthsOtogenic cerebellar abscessesL/CSF; surgery; pus cultureNAVoriconazole (400 mg/day) for 5 monthsAlive
Morioka et al. [14]83/MNeurosurgery/burr hole subdural hematomaApprox. 3 years and 5 monthsSubdural abscess and granulomaSurgical excision histopathologyNAL-AMB (0.25 biweekly intrathecally) + miconazole (500 mg IV daily); adverse reaction; replaced by flucytosine (5 g orally daily)NA
Darras-Joly et al. [15]29/MNeurosurgery/acoustic neurinomaNAMeningitis; abscessL/CSFPositiveL-AMB (5 weeks) + 5-FU (7 weeks); itraconazole (6 months)Alive after 12 months
Letscher et al. [16]20/MFrontal craniectomy/brain traumaNACellulitis/epidural abscess/frontal bone osteomyelitisBrain biopsy, cultureNAABLC × 3 weeks followed by itraconazole for 5 monthsAlive after 3 years
Endo et al. [17]55/MNeurosurgery/pituitary adenomaApprox. 1 yearArachnoiditis; subdural abscessL/abscess aspirationNDAMB + fluconazole (4 weeks)NA
Marinovic et al. [18]65/MCranioplasty for severe craniofacial traumaApprox. 8 yearsMeningitis, abscessL/CSF; stereotactic drainageNAAMB; L-AMB; itraconazoleAlive

GM, galactomannan; AMFB, amphotericin; L-AMB, liposomal amphotericin; ABLC, amphotericin B lipid complex; NA = not available; Approx. = approximately.