An 18-year-old woman was admitted to hospital because of subcutaneous hemat
oma and fever of unknown origin. Acute myeloid leukemia was diagnosed and e
mpirical antimicrobial treatment and induction chemotherapy were started. A
fter initial defervescence, fever relapsed 2 days after the onset of neutro
penia. The CT scan of the lung was consistent with an invasive fungal infec
tion. Treatment with amphotericin B was started and antimicrobial treatment
was continued with liposomal amphotericin B because of an increase in crea
tinine later. The fever persisted and the patient suddenly developed progre
ssive neurological symptoms. CT scan of the head suggested cerebral infarct
ion and angiography of the extra- and intracranial arteries showed signs of
vasculitis. Six days after the onset of neurological symptoms cerebral dea
th was diagnosed. Autopsy revealed non-septate, irregularly branched hyphae
in various histologic sections including brain. Absidia corymbifera could
be isolated from lung tissue confirming the diagnosis of disseminated mucor
mycosis. In this case, angiographic findings suggested severe cerebral vasc
ulitis which was in fact caused by thromboembolic dissemination of fungal h
yphae. This case underlines the fact that cerebral symptoms in febrile neut
ropenic patients are highly indicative for fungal infections of the brain.