Fig. 4.

Central nervous system aspergillosis. A 61-year old man 11 months post–lung transplant presented with right sided headache, double vision, and conjunctivitis. Head imaging demonstrated a right orbital mass. Biopsy demonstrated necrosis, inflammation, and numerous invading narrow-septate hyphae. Cultures grew Aspergillus fumigatus. Patient was treated with liposomal amphotericin B, followed by caspofungin and voriconazole, then ultimately lifelong posaconazole therapy.