Disseminated cerebral aspergillosis complicated by thrombotic microangiopathy

Abstract

Invasive aspergillosis (IA) is a serious condition that can affect almost any organ. Cerebral aspergillosis itself is rapidly fatal without treatment. We report a case of disseminated cerebral IA in a patient exposed to cyclophosphamide, rituximab and prednisone. This case is unique because: 1) disseminated IA has not been described in anti-glomerular basement membrane glomerulonephritis; 2) IA led to thrombotic microangiopathy with normal ADAMTS13 and 3) voriconazole toxicity necessitated use of isavuconazole for IA treatment. Keywords: Invasive aspergillosis, Cerebral aspergillosis, Thrombotic microangiopathy, Voriconazole-induced periostitis, Isavuconazole