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CENTRAL NERVOUS SYSTEM ASPERGILLUS INFECTION AFTER LIVER TRANSPLANTATION: CHALLENGES IN DIAGNOSIS AND TREATMENT
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Abstract
Central nervous system (CNS) Aspergillus infection is a rare but severe complication following liver transplantation, with a very high mortality rate. We report a case of a 66-year-old male patient with a history of non-Hodgkin's lymphoma, type 2 diabetes mellitus, and chronic hepatitis B, who underwent emergency liver transplantation due to acute liver failure. Post-transplant, the patient remained stable and was discharged but was readmitted in the fourth month with prolonged fever, followed by hemiplegia and coma. Cerebrospinal fluid analysis and imaging confirmed Aspergillus fumigatus encephalitis with a ruptured mycotic aneurysm. The patient received intensive antifungal therapy with voriconazole, which was later adjusted to isavuconazole combined with anidulafungin. However, the patient deteriorated with hospital-acquired infections, multi-organ failure, and ultimately succumbed to the illness. This case highlights the critical importance of early diagnosis and optimization of antifungal therapy in transplant recipients.
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Keywords
Invasive fungal infection, Aspergillus, liver transplantation
References
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