Neurology Medical News about aspergillus, abcess, fungal

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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)

Results

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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