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Preoperative antifungal therapy may improve survival in patients with Aspergillus brain abscess
Clinical Neurology and Neurosurgery, 07/29/09
Wasay M et al. – Cerebral aspergillosis is largely a disease of immunocompetent pts (80%), with a overall mortality of 40%. The outcome was significantly better in pts treated with antifungal therapy (especially itraconazole) before surgery, suggesting a possible beneficial effect of pre-surgical treatment with antifungal therapy.
Methods- Study of whether preoperative antifungal therapy positively influences clinical outcome in pts with Aspergillus brain abscess
- Assessment of 25 pts with confirmed diagnosis of cerebral aspergillosis
- Comparison of baseline characteristics and outcomes of pts treated with either amphotericin B or itraconazole either preoperatively (11 pts) or postoperatively (14 pts)
- Comparable baseline clinical characteristics between the 2 treatment groups: age, gender, coma at presentation, immunosuppression, number of abscesses, and interval between presentation and surgery
- Overall outcome significantly better for pts treated with antifungal therapy preoperatively
- All 11 pts who received antifungal therapy preoperatively survived
- Only preoperative itraconazole treatment statistically associated with improved survival vs delayed treatment
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