An Analysis of 141 Cases of Skull Base Aspergillosis Over 11 Years

Background: Invasive intracranial aspergillosis remains a disease with high morbidity and mortality. The rapid increase in the incidence of this disease led us to review the literature and formulate a treatment protocol for such patients.

Material and Methods: Since 2000, a total of 141 patients harboring invasive intracranial aspergillosis were managed under neurosurgical services. Ages ranged from 6 years to 75 years. During the first 5 years of the study, 45 patients were administered amphotericin B, and the last 5 years witnessed a dramatic rise in use of voriconazole (n = 96) as single antifungal chemotherapeutic agent in oral formulation. The radiological profile, hallmark features, and differential diagnoses were noted.

Results: Twenty patients of the 45 treated with amphotericin B expired after getting amphotericin in variable cumulative drug dosages. The outcome improved dramatically after the availability of voriconazole. There were only 4 deaths of 96 patients in the voriconazole group. One of the most common side effects was photosensitivity.

Conclusion: Voriconazole provides better disease control with significantly lower side effects. Long-term results need to be evaluated at prolonged follow-ups.