Aqueductal stenosis and hydrocephalus in an infant due to aspergillus infection

Aqueductal stenosis is a common cause of hydrocephalus during infancy. We r eport on an infant born with aplasia cutis congenita at the scalp vertex an d hypoplastic left heart syndrome developing systemic aspergillosis after c ardiac surgery. The infant died at the age of 76 days despite systemic anti mycotic therapy with a combination of flucytosine and amphotericin B. Thera py started at post-operative day 17 and was also applied intrathecally. Pos t-examination revealed meningitis,multiple brain aspergillomas and microabs cesses with focal ependymitis, focal bronchopneumonia, and necrotizing ente rocolitis. One of the brain aspergillomas was located close to the aqueduct causing an aqueductal stenosis and an obstructive hydrocephalus. Histologi cally, aspergillus hyphae could only be detected in the aspergilloma of the aqueduct. To the best of our knowledge, this is the first reported case of an aqueductal stenosis caused by an aspergilloma.