Title

Preoperative antifungal therapy may improve survival in patients with Aspergillus brain abscess

Document Type

Article

Department

Neurology

Abstract

Objective: The objective of this study was to determine if the preoperative use of antifungal therapy positively influences clinical outcome in Patients with Aspergillus brain abscess. Methods:We studied 25 Patients with confirmed diagnosis of cerebral aspergillosis. We compared baseline characteristics and outcomes of Patients treated with either amphotericin B or itraconazole either pre-operatively (n = 11) or post-operatively (n = 14) at a tertiary care hospital in Karachi.

Results:

Twenty-five Patients were included in the study. Cerebral aspergillosis was largely a disease of immune competent people (80%). Baseline clinical characteristics between the two treatment groups were comparable i.e., age (P>0.896), gender (P>0.999), coma at presentation (P>0.999), immunosuppression (P>0.623), number of abscesses (P>0.999) and interval between presentation and surgery (P>0.447). Overall mortality was 40%. The overall outcome was significantly better (PConclusion: Cerebral aspergillosis was largely a disease of immune competent people (80%). Overall mortality was 40%. The outcome was significantly better in Patients treated with antifungal therapy (especially itraconazole) before surgery suggesting a possible beneficial effect of pre-surgical treatment with antifungal therapy.

Publication

Clinical Neurology and Neurosurgery