Invasive intracranial aspergillosis: the management dilemmas

BackgroundInvasive intracranial aspergillosis remains a disease with high morbidity and mortality. The rapid increase in the incidence of this disease led us to review the literature and formulate a treatment protocol for such patients.MethodsAn analysis of 46 patients with invasive intracranial aspergillosis is presented and the subgroups of extradural and intradural variety are evaluated with different treatment strategies.ResultsPatients with extradural form of disease had 100% survival, whereas antifungal chemotherapy preloading tends to provide a better outcome.ConclusionsExtradural aspergillosis does not need chemotherapy preloading, whereas intradural variant may have improved survival chances after preloading. Liposomal formulation has an advantage of shortened time duration for preloading, because the daily administration dose is 6 times higher than conventional preparation.