Fungal cerebellar tonsillar abscess as a cause of quadriparesis.

Of the two reported immunocompetent patients with an isolated cerebellar aspergilloma, one was an adult[3] and another was an infant (his immune status being debatable).[4] The source of infection in our patient is unclear. Though Aspergillus is known to reside in tuberculous cavities, the chest X-rays did not reveal cavitatory lesions or a fungal ball. The other possibility is that he suffered from a pulmonary aspergillus infection initially which was misdiagnosed as tuberculosis but this is unlikely as he recovered with antituberculous therapy. Patients with isolated fungal granulomas of the brain may be subjected to prolonged anti-tuberculous therapy empirically, leading to delay in diagnosis and administration of antifungal treatment, resulting in a poor outcome.[1] A high index of suspicion is required to order fungal culture studies. Total excision of the mass followed by adequate antifungal therapy, as was undertaken in our case, is likely to result in a cure.