Case report demonstrates fatal rupture of an intracranial mycotic aneurysm following Scedosporium apiospermum sphenoid sinusitis in an elderly patient, highlighting rapid fungal vascular invasion.
An 85-year-old man complained of a 2-month history of pain on the left side of his face. Brain computed tomography (CT) and magnetic resonance imaging/magnetic resonance angiography did not clearly show any intracranial abnormality and only showed fluid effusion in his left sphenoid sinus. Filamentous fungi were detected from the left sphenoid sinus specimen. The isolate was Scedosporium apiospermum. He was empirically treated with voriconazole, to which the isolate was susceptible. His consciousness decreased rapidly. Urgent 3D-CT angiography revealed an intracranial aneurysm near the left sphenoid sinus. Despite urgent coil embolization, the aneurysm ruptured, and he died.
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