86 https://www.id-press.eu/mjms/index Scientifc Foundation SPIROSKI, Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. 2020 Aug 15; 8(C):86-88. https://doi.org/10.3889/oamjms.2020.3563 eISSN: 1857-9655 Category: C - Case Reports Section: Case Report in Surgery Cerebral Aspergilloma in Patient with Diabetes – A Case Report with Short Literature Review Koni Ivanova 1 *, Stefan Valkanov 2 , Bozhidar Petrov 2 , Ivan Mindov 2 , Maya Gulubova 1 1 Department of General and Clinical Pathology, Trakia University, Faculty of Medicine, Stara Zagora, Bulgaria; 2 Department of Neurosurgery, Trakia University, Faculty of Medicine, Stara Zagora, Bulgaria Abstract BACKGROUND: In the recent years, the incidence of fungal brain abscess has been rising as a result of the increased use of corticosteroid therapy, broad-spectrum antimicrobial therapy, and immunosuppressive agents. Aspergillosis of the central nervous system (CNS) is reported in 10%–20% of the patients having invasive fungal disease. Commonly, the disease is observed in immunocompromised or immunosuppressed patients; also, patients who sufered traumatic head injury are reported as well to develop the infection due to due cranial defect accompanied by dural tearing. Symptoms are non-specifc neurologic manifestations. CASE PRESENTATION: We presented a case of a 68-year-old man who had diabetes mellitus type II. He was admitted to in neurosurgery clinic due reported head trauma. Initially, he complained of a headache, dizziness, slurred speech, nausea, and pain in the right ear with tinnitus and pain in his right upper teeth – continuous for a month. The patient was conscious, adequate, Glasgow Coma Scale – 15 points, with left-sided hemiparesis, general symptomatic syndrome. An emergent computed tomography scan was performed, which showed tumorous formation in patient’s right temporal lobe that had mass efect and compression of the right lateral ventricle. The patient was discussed on a emergent clinical counsel and it was decided that he was shown for surgical treatment. An informed consent was signed by the patient and his relatives. After the surgery intervention – the histological result of the biopsy was aspergilloma of the brain and the microbiological result was Aspergillus fumigatus. CONCLUSION: The prognosis for CNS aspergillosis is poor, but the early diagnosis and efective medical and surgical treatments may reduce morbidity and mortality. Introduction Aspergillosis of the central nervous system (CNS) is reported in 10%–20% of the patients having invasive fungal disease. Commonly, the disease is observed in immunocompromised or immunosuppressed patients, also patients who sufered traumatic head injury are reported as well to develop the infection due to the cranial defect accompanied by dural tearing [1], [2]. Aspergillosis of brain is rare condition and commonly seen in immunocompromised or immunosuppressed patients, such as patients with hematopoietic stem cell transplant, AIDS, patients on immunosuppressive drugs, uncontrolled diabetes mellitus, and some patients with cancer [3], [4]. There are various pathologic presentation forms of this infection: Aseptic and persistent meningitis, mycotic aneurysm, ischemic and hemorrhagic infarcts, and the tumor-like form or aspergilloma [5], [6]. Aspergillus infection could reach the brain directly from the nasal sinuses through vascular channels (contiguous source 25%–50% of the cases), also from the lungs (most commonly) and gastrointestinal system by blood borne (hematogenous dissemination 20%–35%). Trauma could lead to brain abscess formation as a result of an open cranial fracture with dural breach or foreign body injury or as a sequela of neurosurgery – and the reported incidence is 2.5%–10%. [7], [8], [9]. Aspergillosis of the CNS is an infrequent medical condition and does not have a specifc imaging pattern and hence poses a difcult diagnostic challenge, carry higher risks of morbidities and mortality as compared to other infective processes [10]. The most common presenting symptoms are non-specifc neurologic manifestations – general brain symptomatic and/or also focal neurologic symptoms, depending on the localization of the process [11]. In this article, we present a case of patient with cerebral aspergilloma. Case Report A 68-year-old man was brought to the emergency department. He complained of a headache, complained of dizziness, slurred speech, nausea, tinnitus, and pain in the right ear and also right upper teeth continuing a month. There was no history of fever. He has diabetes type II, adenoma of the prostate gland and has amputation of the left arm. Hematological and Edited by: Sinisa Stojanoski Citation: Ivanova K, Valkanov S, Petrov B, Mindov I, Gulubova M. Cerebral Aspergilloma in Patient with Diabetes – A Case Report with Short Literature Review. Open Access Maced J Med Sci. 2020 Aug 15; 8(C):86-88. https://doi.org/10.3889/oamjms.2020.3563 Keywords: Aspergillus; Fungal infection; Fungal granuloma; Central nervous system; Craniotomy *Correspondence: Koni Ivanova, Department of General and Clinical Pathology, Trakia University, Faculty of Medical, Stara Zagora. Str. Armeska 11, Stara Zagora. E-mail: koni_ivanova@yahoo.com Received: 21-Aug-2019 Revised: 30-Jun-2020 Accepted: 03-Jul-2020 Copyright: © 2020 Koni Ivanova, Stefan Valkanov, Bozhidar Petrov, Ivan Mindov, Maya Gulubova Funding: This study was supported by the National Scientifc Programme for support of young scientists and post-doctoral scientists second year 2020, administered by the Ministry of Education and Science, Bulgaria with decision No. 577/17.08.2018 Competing Interests: The authors have declared that no competing interests exist Open Access: This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial 4.0 International License (CC BY-NC 4.0)