Cerebral Aspergillus penicillioides infection mimicking schwannoma in an immunocompetent host: case report with a review of the literature.

BACKGROUND

Central nervous system aspergillosis is a rare and severe condition with high mortality and frequent diagnostic delay. Infection due to Aspergillus penicillioides in this setting is rarely reported.

CASE PRESENTATION: We describe a rare case of cerebral infection caused by A. penicillioides in an immunocompetent patient, initially mistaken for a schwannoma. Histopathological examination revealed hyaline septate hyphae, and molecular analysis of formalin-fixed and paraffin-embedded (FFPE) tissue supported the identification by sequencing of a fragment of the 28S rRNA gene. Following an initial surgical resection, clinical deterioration ensued, necessitating a repeat procedure and targeted antifungal therapy, which ultimately led to disease stabilization and outpatient discharge.

CONCLUSION

This case highlights the diagnostic difficulties and therapeutic challenges posed by rare Aspergillus species in immunocompetent hosts.