Despite intense oral and intravenous antifungal therapy, contiguous spread of the primary pulmonary infection to 2 adjacent ribs occurred. Failure to control the infection led to a surgical resection of her right inferior lobe. After4 months of antifungal treatment (Caspofungine +Itraconazole) and administration of IFN- ȣ, despite the particular improvement in her general and respiratory condition, she suddenly developed unilateral colonic seizures, vomiting and loss of consciousness. Cranial CT Scan revealed an acute non-communicating hydrocephalus with dilated bilateral and third ventricles that was interpreted to a blockage in cfs circulation at forth ventricle level by fungal infection or granuloma formation (Figure 3). Placing an external ventricle drainage, increased her level of consciousness and after a while a ventriculo-peritoneal shunt was replaced and her antifungal regiment was changed to Voriconazole plus Caspofungin. But 2 weeks later she developed fever, refractory seizures and coma. She was intubated and despite the obvious changes in CSF cells
Despite intense oral and intravenous antifungal therapy, contiguous spread of the primary pulmonary infection to 2 adjacent ribs occurred. Failure to control the infection led to a surgical resection of her right inferior lobe. After4 months of antifungal treatment (Caspofungine +Itraconazole) and administration of IFN- ȣ, despite the particular improvement in her general and respiratory condition, she suddenly developed unilateral colonic seizures, vomiting and loss of consciousness. Cranial CT Scan revealed an acute non-communicating hydrocephalus with dilated bilateral and third ventricles that was interpreted to a blockage in cfs circulation at forth ventricle level by fungal infection or granuloma formation (Figure 3). Placing an external ventricle drainage, increased her level of consciousness and after a while a ventriculo-peritoneal shunt was replaced and her antifungal regiment was changed to Voriconazole plus Caspofungin. But 2 weeks later she developed fever, refractory seizures and coma. She was intubated and despite the obvious changes in CSF cells