Cerebral aspergillosis caused by Aspergillus granulosus

Abstract

Disseminated disease by Aspergillus granulosus has been reported only once previously in a cardiac transplant recipient. We report a fatal central nervous system infection in a lung transplant recipient. Key features of this species in the section Usti include growth at 37 degrees C and large, randomly spaced aggregates of variably shaped Hülle cells.

FIG. 1.

(A) The thrombosed left middle cerebral artery was surrounded by granulomatous inflammation in the meninges (hematoxylin and eosin; original magnification, ×20). (Inset) The fungal hyphae were nonpigmented and septate (hematoxylin and eosin; original magnification, ×400). (B) Silver stain highlights the fungal hyphae within the thrombus and extending through the arterial wall (Gomori methenamine silver; 100× original magnification).

FIG. 2.

(A) PFA (top) and CZA (bottom) plates incubated for 14 days at 25°C. (B) Clusters of Hülle cells on the slide culture in lacto-fuchsin mounting medium. (C) Slide culture mounted in lactophenol cotton blue showing a more robust, biseriate fruiting head demonstrating metulae and bottle-shaped phialides of almost equal length. (D) Globose, finely echinulate conidia borne from a solitary phialide (lactophenol cotton blue mount).