Silent Fungal Invasion: A Case of Aspergillus Brain Abscesses in an Immunocompetent Older Adult Patient.

Abstract

Brain abscesses caused by fungal pathogens are uncommon in immunocompetent individuals. An 84-year-old man presented with fever and headache. Brain imaging identified a nonspecific right frontal lesion. He returned with worsening symptoms and confusion after two weeks, with magnetic resonance imaging (MRI) revealing multiple abscesses with ring enhancement. Cultures from surgical resection and drainage samples grew Aspergillus. Despite antifungal therapy, his neurological condition declined. This case highlights the importance of considering fungal pathogens in older patients with nonspecific brain lesions, even without focal neurological symptoms or evidence of a primary infection.