Successful treatment with voriconazole of cerebral aspergillosis in an hematologic patient.

Invasive aspergillosis in hematologic patients is an opportunistic infection difficult to treat. The infection localisation in the central nervous system has a high mortality rate. We describe a patient with advanced chronic lymphocytic leukaemia with a high grade of immunodepression, who developed pulmonary and cerebral aspergillosis resistant to amphotericin B deoxycolate during treatment with humanised monoclonal antibody anti CD52. After 20 days of amphotericin B therapy (total dose 775 mg) a magnetic resonance imaging of the brain and CT scan of the chest showed cerebral lesion and increased size of the pulmonary localisation. Oral therapy with voriconazole (until death after 7 months) permitted the continuation of palliative chemotherapy and resulted in complete resolution of the cerebral lesions and marked an improvement of the pulmonary lesion