Central nervous system aspergillosis in immunocompetent patient

Central nervous system aspergillosis has increased dramatically in recent years. Most patients are immunocompromised and infected from a primary site, usually the lungs or paranasal sinuses, from where the organism spreads to the central nervous system. We report the case of a 7-year-old immunocompetent girl who presented with high-grade fever with chills and developed hemiplegia with facial palsy. Imaging showed multiple, confluent, infiltrative ring enhancing lesions in the right cerebral hemisphere associated with perilesional edema and mass effect. On craniotomy, the lesion was an abscess, which was drained. Histological examination of the abscess wall showed aspergillus hyphae. The patient died 12 days after surgical drainage.