Surgical and Medical Treatment Impact on Survival Among Cerebral Aspergillosis: Systematic Review of the Literature.

Abstract Objective Cerebral aspergillosis carries a high mortality rate. Rapid diagnosis and treatment can increase survival, but symptoms and imaging findings are nonspecific. The literature on cerebral aspergillosis consists mostly of case report and case series, lacking large scale review of data. Methods We performed a review of the literature using PubMed in March 2019. We recorded the year of publication, age and sex of patients, neurosurgical involvement, the antifungals administered, use of intrathecal antifungals, and the outcome of patients. The relationships between variables were tested using bivariant statics and linear regression. Results A total of 324 studies met the eligibility criteria, and 199 studies including 248 patients were included. Surgical resection (OR - .45, 95% CI 0.25-0.80, p Conclusion Given the significant survival benefits for patients who received voriconazole and surgical intervention, we suggest early antifungal medical treatment and resection.