JVATiTD - Articles
Official publication of CEVAP/UNESP
Cerebral Aspergillus penicillioides infection mimicking schwannoma in an immunocompetent host: case report with a review of the literature
William Kazunori Sekiguchi¹, Juliana Possatto Fernandes Takahashi², Jessica de Brito Ferreira Nascimento², Camila da Silva Santos Ferreira², Matheus Polly¹, Wilker Dias Martins³, Bruno Evangelista de Toledo⁴, Thales Bhering Nepomuceno⁴, Vinicius Trindade Gomes da Silva⁴, Ana Catharina de Seixas Santos Nastri¹, Amaro Nunes Duarte Neto³, Marcello Mihailenko Chaves Magri¹, ⁵ [ + show more ]
Received: 14 December 2025 | Accepted: 07 April 2026 | Published online: 01 June 2026
https://doi.org/10.1590/1678-9199-JVATITD-2025-0091
Abstract
Background: Central nervous system aspergillosis is a rare and severe condition with high mortality and frequent diagnostic delay. Infection due to Aspergillus penicillioides in this setting is rarely reported. Case presentation: We describe a rare case of cerebral infection caused by A. penicillioides in an immunocompetent patient, initially mistaken for a schwannoma. Histopathological examination revealed hyaline septate hyphae, and molecular analysis of formalin-fixed and paraffin-embedded (FFPE) tissue supported the identification by sequencing of a fragment of the 28S rRNA gene. Following an initial surgical resection, clinical deterioration ensued, necessitating a repeat procedure and targeted antifungal therapy, which ultimately led to disease stabilization and outpatient discharge. Conclusion: This case highlights the diagnostic difficulties and therapeutic challenges posed by rare Aspergillus species in immunocompetent hosts.
Keywords:
Aspergillus penicillioides; Cerebral aspergillosis; Hyalohyphomycosis; Immunocompetent host; Neoplasm mimic