Craniocerebral aspergillosis in immunocompetent hosts: surgical perspective

Muhammad Shahzad Shamim, Aga Khan University
Arshad A Siddiqui, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
S. Ather Enam, Aga Khan University
Ahmed Ali Shah, Aga Khan University
Rashid Jooma, Aga Khan University
Saleha Anwar, Liaquat National Postgraduate Medical Centre, Karachi


Craniocerebral aspergillosis is a rare but dangerous variety of central nervous system infections. Surgery is being widely recognized as the cornerstone of management. Due to the rarity of the disease, difficulty and delay in diagnosis and poor outcome, there is very little in the literature regarding the various surgical strategies that may be adopted in these patients. Early aggressive surgery followed by chemotherapy offers the best chances. Surgical planning would depend upon the type and location of the disease process as well as the condition of the patient. Perioperative care holds immense importance and knowledge of possible complications is essential. Aspergillosis of the central nervous system is difficult to diagnose and equally difficult to treat. Surgery remains the cornerstone of management followed by systemic antifungal medications. Results are better in immunocompetent patients as compared to those who are immunocompromised.