Skip to main content
PMC home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1990 Feb;43(2):114–118. doi: 10.1136/jcp.43.2.114

Cerebral aspergillosis in liver transplantation.

A P Boon 1, D H Adams 1, J Buckels 1, P McMaster 1
PMCID: PMC502290  PMID: 2101577

Abstract

Nine cases of cerebral aspergillosis were identified in a series of 44 brains obtained at necropsy from patients who had undergone liver transplantation. In two of these there was dual infection with Candida albicans. The primary focus of infection was invariably in the lungs. One case of pulmonary Aspergillus infection was found with no evidence of cerebral disease. Infection tended to occur in the period soon after transplantation, was associated with high dose steroids, retransplantation, and showed a significant seasonal incidence. Neurological findings were non-specific and only two cases were diagnosed before death. Aspergillus infection soon after transplantation indicates that this organism is a considerable nosocomial hazard, particularly in the winter and spring months. Positive cultures before death are rarely obtained and antifungal treatment should be started on clinical suspicion alone.

Full text

PDF
115

Images in this article

115Image
on p.115
116Image
on p.116
117Image
on p.117

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adams D. H., Burnett D., Stockley R. A., Hubscher S. G., McMaster P., Elias E. Biliary beta 2-microglobulin in liver allograft rejection. Hepatology. 1988 Nov-Dec;8(6):1565–1570. doi: 10.1002/hep.1840080616. [DOI] [PubMed] [Google Scholar]
  2. Adams D. H., Ponsford S., Gunson B., Boon A., Honigsberger L., Williams A., Buckels J., Elias E., McMaster P. Neurological complications following liver transplantation. Lancet. 1987 Apr 25;1(8539):949–951. doi: 10.1016/s0140-6736(87)90294-7. [DOI] [PubMed] [Google Scholar]
  3. Boon A. P., Adams D. H., Carey M. P., Williams A., McMaster P., Elias E. Cyclosporin-associated cerebral lesions in liver transplantation. Lancet. 1988 Jun 25;1(8600):1457–1457. doi: 10.1016/s0140-6736(88)92263-5. [DOI] [PubMed] [Google Scholar]
  4. Boon A. P., Carey M. P., Salmon M. V. Central pontine myelinolysis not associated with rapid correction of hyponatraemia. Lancet. 1988 Aug 20;2(8608):458–458. doi: 10.1016/s0140-6736(88)90452-7. [DOI] [PubMed] [Google Scholar]
  5. Conti D. J., Rubin R. H. Infection of the central nervous system in organ transplant recipients. Neurol Clin. 1988 May;6(2):241–260. [PubMed] [Google Scholar]
  6. Hooper D. C., Pruitt A. A., Rubin R. H. Central nervous system infection in the chronically immunosuppressed. Medicine (Baltimore) 1982 May;61(3):166–188. doi: 10.1097/00005792-198205000-00004. [DOI] [PubMed] [Google Scholar]
  7. Kaplan K. Brain abscess. Med Clin North Am. 1985 Mar;69(2):345–360. [PubMed] [Google Scholar]
  8. Martinez A. J., Estol C., Faris A. A. Neurologic complications of liver transplantation. Neurol Clin. 1988 May;6(2):327–348. [PubMed] [Google Scholar]
  9. Martinez A. J., Puglia J. The neuropathology of liver, heart, and heart-lung transplantation. Transplant Proc. 1988 Feb;20(1 Suppl 1):806–809. [PubMed] [Google Scholar]
  10. Nalesnik M. A., Myerowitz R. L., Jenkins R., Lenkey J., Herbert D. Significance of Aspergillus species isolated from respiratory secretions in the diagnosis of invasive pulmonary aspergillosis. J Clin Microbiol. 1980 Apr;11(4):370–376. doi: 10.1128/jcm.11.4.370-376.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Park G. R., Drummond G. B., Lamb D., Durie T. B., Milne L. J., Lambie A. T., Cameron E. W. Disseminated aspergillosis occurring in patients with respiratory, renal, and hepatic failure. Lancet. 1982 Jul 24;2(8291):179–183. doi: 10.1016/s0140-6736(82)91029-7. [DOI] [PubMed] [Google Scholar]
  12. Schneider A. B., Shore-Freedman E., Ryo U. Y., Bekerman C., Favus M., Pinsky S. Radiation-induced tumors of the head and neck following childhood irradiation. Prospective studies. Medicine (Baltimore) 1985 Jan;64(1):1–15. doi: 10.1097/00005792-198501000-00001. [DOI] [PubMed] [Google Scholar]
  13. Seaton A., Robertson M. D. Aspergillus, asthma, and amoebae. Lancet. 1989 Apr 22;1(8643):893–894. doi: 10.1016/s0140-6736(89)92877-8. [DOI] [PubMed] [Google Scholar]
  14. Seigler H. F., Fetter B. F. Current management of melanoma. Ann Surg. 1977 Jul;186(1):1–12. doi: 10.1097/00000658-197707000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Starzl T. E., Schneck S. A., Mazzoni G., Aldrete J. A., Porter K. A., Schröter G. P., Koep L. J., Putnam C. W. Acute neurological complications after liver transplantation with particular reference to intraoperative cerebral air embolus. Ann Surg. 1978 Mar;187(3):236–240. doi: 10.1097/00000658-197803000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Trull A. K., Parker J., Warren R. E. IgG enzyme linked immunosorbent assay for diagnosis of invasive aspergillosis: retrospective study over 15 years of transplant recipients. J Clin Pathol. 1985 Sep;38(9):1045–1051. doi: 10.1136/jcp.38.9.1045. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Vogt D. P., Lederman R. J., Carey W. D., Broughan T. A. Neurologic complications of liver transplantation. Transplantation. 1988 Jun;45(6):1057–1061. doi: 10.1097/00007890-198806000-00011. [DOI] [PubMed] [Google Scholar]
  18. Walsh T. J., Hier D. B., Caplan L. R. Aspergillosis of the central nervous system: clinicopathological analysis of 17 patients. Ann Neurol. 1985 Nov;18(5):574–582. doi: 10.1002/ana.410180511. [DOI] [PubMed] [Google Scholar]
  19. Walsh T. J., Hier D. B., Caplan L. R. Fungal infections of the central nervous system: comparative analysis of risk factors and clinical signs in 57 patients. Neurology. 1985 Nov;35(11):1654–1657. doi: 10.1212/wnl.35.11.1654. [DOI] [PubMed] [Google Scholar]
  20. de Groen P. C., Aksamit A. J., Rakela J., Forbes G. S., Krom R. A. Central nervous system toxicity after liver transplantation. The role of cyclosporine and cholesterol. N Engl J Med. 1987 Oct 1;317(14):861–866. doi: 10.1056/NEJM198710013171404. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES