A case report of disseminated aspergillosis in an immunocompetent patient proven by choroid plexus biopsy

We present a case of disseminated aspergillosis diagnosed by choroid plexus biopsy in an immunocompeten 69-year-old male with decreased consciousness and a fever for more than three months. Brain magnetic resonance imaging showed ventriculitis and phlegmon in the paravertebral space. Chest computerized tomography revealed an air-crescent lesion in the upper lobe of the left lung. No microorganism was identified from the blood or CSF cultures. A choroid plexus biopsy was performed and the pathology findings were consistent with fungal abscess caused by invasive aspergillosis. Since disseminated aspergillosis in the immunocompetent patient is very rare, it was difficult to diagnose this invasive fungal infection in this case. Because the choroid plexus has many blood vessels, there is a high risk of bleeding during biopsy. This was a case in which adequate suspicion and an aggressive diagnostic approach were helpful in the management of a patient with an invasive fungal infection.