University of Wisconsin–Madison Medical College of Wisconsin

Locally Invasive Central Nervous System Aspergillosis Presenting as Subacute Vision Loss

Amelia Papadimitriou, MPH; Alenna Beroza, MS; Kriti Behl, APNP; Muhammad Hammad, MD; Roshan Thapa, MD; Pinky Jha, MD, MPH

WMJ. 2025;124(3):296-299.

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ABSTRACT

Introduction: Aspergillus is a ubiquitous environmental fungus that has the potential to cause a wide array of clinical illnesses, from an allergic response to invasive disseminated disease – particularly in those with immune dysfunction or underlying disease.

Case Presentation: An 83-year-old immunocompromised man presented to the emergency department with fever and subacute vision loss over 3 to 4 months after multiple prior emergency department and outpatient ophthalmology visits. After a complicated course, locally invasive central nervous system aspergillosis was diagnosed. Although the patient eventually recovered, he experienced permanent vision loss.

Discussion: This case demonstrates the importance of aggressive workup in immunosuppressed patients with onset of any concerning ocular or other symptoms. A multidisciplinary approach is necessary for optimal patient outcomes.

Conclusions: Aspergillosis has the potential to cause devastating disease and long-term consequences in immunocompromised patients. Clinicians should be alerted to the importance of early detection and intervention for this population.


Author Affiliations: Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin (Papadimitriou, Beroza, Behl, Hammad, Thapa, Jha).
Corresponding Author: Amelia Papadimitriou, MPH, 8701 W Watertown Plank Rd, Milwaukee, WI 53226; email apapadimitri@mcw.edu; ORCID ID 0009-0005-4925-0021
Financial Disclosures: None declared.
Funding/Support: None declared.
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