Intracranial Fungal Granuloma Mimicking Neoplastic Lesion: Diagnostic Dilemma and Role of Voriconazole as Treatment Strategy

ABSTRACT Fungal infections of the central nervous system (CNS) usually present as subacute meningitis or intracranial space occupying lesion with mass effect on surrounding structures and consequent focal neurological deficits. Intracranial fungal granulomas are often misdiagnosed clinically and radiologically as neoplastic lesions.  Biopsy of the lesion is the only reliable technique to establish the correct diagnosis as well as detect the causative fungal species. Voriconazole is a broad spectrum triazole antifungal agent. It can be given orally and iv and has lesser adverse effects. in this article we report a series of six cases of biopsy proven fungal granuloma with varied clinical and radiological presentations who were given treatment with voriconazole for 6 months and demonstrated favorable response. Conclusion-  Our series focuses on  the correct diagnosis of fungal granuloma which can be achieved by biopsy and clinical evidence of efficacy of voriconazole against intracranial fungal granuloma.