Aspergillus fumigatus, in the form of branching septate hyphae, measures 4 to 7 microns. The primary infection is usually a necrotizing hemorrhagic pneumo-nitis. From the lungs, the fungi reach the cerebral blood vessels, where they produce a necrotizing vascu-litis and, subsequently, a septic hemorrhagic necrosis (Fig. 6.22).

Aspergillus may also invade the brain from infected paranasal sinuses, orbits, or ears to cause a meningitis. Abscesses and granulomas are common in disseminated aspergillosis. They may reach large sizes and cause increased intracranial pressure and mass effects (Fig. 6.23).

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