Neurological Sciences

, Volume 39, Issue 10, pp 1795–1796 | Cite as

Dual infectious brainstem encephalitis with Aspergillus flavus and Haemophilus influenza in an immunocompetent patient

  • Athanasios Papathanasiou
  • Rasha Abdel-Fahim
  • Nikos Evangelou
Letter to the Editor

Dear Editor-in-Chief,

Brainstem encephalitis (BE) can be infectious, autoimmune, or paraneoplastic [1]. Fungi are very rare causes of BE, typically affecting immunocompromised patients [1].

A 60-year-old female of Zimbabwean origin was admitted with 2-day history of headache, fever, and weakness in all her limbs. Her past medical history included nasal congestion for the last 6 months. On neurological examination, the patient was confused with a right-sided upper motor neuron facial nerve palsy, a right abducens palsy, and an asymmetric quadriparesis. C-reactive protein on admission was 157 mg/L. Cerebrospinal fluid (CSF) examination revealed marked polymorphic pleocytosis (1430 polymorphs and 30 lymphocytes), increased protein of 2583 mg/L, and low glucose of 2.9 mmol/L. Haemophilus species were identified on CSF culture and CSF polymerase chain reaction (PCR).

Brain magnetic resonance imaging (MRI) showed a diffuse T2 hyperintensity in the pons (Fig.  1a) with oedematous changes...


Authors’ contribution

The authors have approved the submission of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neurology, Queen’s Medical CentreNottingham University Hospitals NHS TrustNottinghamUK
  2. 2.Division of Clinical NeurologyUniversity of NottinghamNottinghamUK

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