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Genzen JR et al. – Aspergillus terreus was identified in an intradural spinal biopsy specimen from an African female with recurrent headache and hydrocephalus. Prior laboratory testing of cerebrospinal fluid was nondiagnostic, despite extensive central nervous system involvement. CNS Aspergillus infection presents a diagnostic and therapeutic challenge and is reviewed in the context of this particularly instructive and difficult case.

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