Tomoko Okazaki    Department   Kawasaki Medical School  Kawasaki Medical School, Department of Stroke Medicine,    Position
Article types	症例報告
Language	Japanese
Peer review	Peer reviewed
Title	Extended voriconazole theraphy and long term survival of a patient with invasive central aspergillosis causing stroke
Domestic / Foregin	Domestic
Volume, Issue, Page	pp.472-7
Author and coauthor	Tomoko Okazaki, Shoichi Shiraishi, Naoki Iwasa, Emi Kitamura, Tetsu Mizutani, Yukiko Hanada, Takehiko Yanagihara
Publication date	2015/07
Summary	Central nervous system (CNS) aspergillosis with stroke has a high mortality and poor prognosis generally. We report a 78-years-old woman with diabetes mellitus, who developed invasive paranasal sinus aspergillosis with the orbital apex syndrome on the right side and cerebral infarction caused by intracranial occlusion of the right internal carotid artery. Based on the presence of a mass lesion in the ethmoid sinus extending to the orbital apex on the right side with cranial CT, the mass lesion was surgically removed and the pathological examination of the surgical specimen revealed aspergillus mold. Immediately after surgery, we initiated treatment with voriconazole 200 mg × 2/day intravenously for 38 days, and then via feeding tube for 86 days until the galactomannan-aspergillus antigen level in the cerebrospinal fluid became negative at 132 days. She is alive now for almost two years without relapse of aspergillosis. There is no definitive guideline for management of patients with CNS aspergillosis concerning the length of drug treatment and the method for monitoring the response for treatment. We believe that measurement of the galactomannan-aspergillus antigen level in the cerebrospinal fluid might be a useful way of monitoring the efficacy of treatment for CNS aspergillosis.
DOI	10.5692/clinicalneurol.cn-000668
PMID	26041392