Aspergillus flavus as a surprise space occupying lesion in an immunocompetent pediatric patient

Abstract Background Fungal infections of the CNS are almost always a clinical surprise. Aspergillus species although ubiquitous more frequently observed in immuno-compromised individuals upon inhalation conidia. Most fungal which happen humans opportunistic, mostly due to immunocompromised host. Case description We present case 14-year-old boy who presented Emergency Department Aga Khan University Hospital, Karachi, with complaints right-sided weakness body. This was rapid-onset condition associated gait disturbances and multiple episodes vomiting. MRI head showed encapsulated Space Occupying Lesion puss left frontal lobe surrounding edema. The patient planned for craniotomy remove an intracerebral abscess. Histopathology report revealed presence chronic granulomatous inflammation necrosis numerous septate hyphae. A fungus culture run confirmed heavy colonies flavus . Conclusion central nervous system surprise, have subtle presentation mistaken often as meningitis, brain abscess, or tumor. Any suspected lesion once removed should be sent biopsy rule out any infection.