Locally Invasive Central Nervous System Aspergillosis Presenting as Subacute Vision Loss.

Abstract

Introduction: Aspergillus is a ubiquitous environmental fungus that has the potential to cause a wide array of clinical illnesses, from an allergic response to invasive disseminated disease - particularly in those with immune dysfunction or underlying disease.

Case presentation: An 83-year-old immunocompromised man presented to the emergency department with fever and subacute vision loss over 3 to 4 months after multiple prior emergency department and outpatient ophthalmology visits. After a complicated course, locally invasive central nervous system aspergillosis was diagnosed. Although the patient eventually recovered, he experienced permanent vision loss.

Discussion: This case demonstrates the importance of aggressive workup in immunosuppressed patients with onset of any concerning ocular or other symptoms. A multidisciplinary approach is necessary for optimal patient outcomes.

Conclusions: Aspergillosis has the potential to cause devastating disease and long-term consequences in immunocompromised patients. Clinicians should be alerted to the importance of early detection and intervention for this population.