Early diagnosis of central nervous system aspergillosis with combination use of cerebral diffusion-weighted echo-planar magnetic resonance image and polymerase chain reaction of cerebrospinal fluid

We treated a patient diagnosed as central nervous system (CNS) aspergillosi s with the combined use of cerebral diffusion-weighted echo-planar magnetic resonance imaging (DWI) and polymerase chain reaction of the cerebrospinal fluid (CSF-PCR), DWI, a cutting-edge imaging modality to reveal the earlie st changes of cerebral infarction, detected cerebral fungal embolization wh en the conventional computed tomographic scan and magnetic resonance imagin g failed to reveal it. CSF-PCR demonstrated the presence of Aspergillus-spe cific DNA in the specimen, when the conventional examination and culture of CSF were nonspecific or negative. These diagnostic methods could be useful in the early diagnosis of CNS aspergillosis.