An unusual case of invasive rhino-cerebral aspergillosis in a pediatric patient: A case report with diagnostic approach and imaging review.

Cerebral aspergillosis is a rare and often fatal fungal infection, particularly in immunocompromised individuals. Diagnosis is challenging due to nonspecific clinical and radiological findings. We report the case of a 14-year-old girl with a history of type 1 diabetes who presented with severe diabetic ketoacidosis, rapidly followed by altered consciousness and a necrotic nasal lesion. Radiological investigations revealed multifocal hemorrhagic infarcts and abscesses, and a biopsy confirmed invasive rhino-cerebral aspergillosis due to Aspergillus fumigatus. Despite prompt antifungal therapy with voriconazole, the patient succumbed to the disease. This case underscores the aggressive nature of this infection in diabetic patients and emphasizes the critical role of early neuroimaging when clinical suspicion arises.