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Serial magnetic resonance angiography in a patient with angioinvasive aspergillosis

Angioinvasive aspergillus can lead to acute infarction. A 74‐year old man complained about mild weakness of the left limbs; based on diffusion‐weighted magnetic resonance imaging, he was diagnosed with acute infarction in the right caudate and anterior limb of the internal capsule. After admission, he had a fever with disturbance of consciousness. Elevated serum β‐D‐glucan, elevated galactomannan antigen titers in cerebrospinal fluid and histopathological analysis on a biopsy specimen of the right sphenoid sinus enabled a diagnosis of Aspergillus infection. Serial magnetic resonance angiography showed the progressing stenosis of the major cerebral artery by angioinvasive aspergillosis with the spread of the cerebral infarction. Our case suggests that serial magnetic resonance angiography might be useful for monitoring progression of aspergillus vasculopathy.