Cranial Vault Lesions
Cranial fungal infection is a rare disease. Often located in the skull base, few cases of cranial vault involvement have been reported in fungal infections. The calvaria may be involved by various fungal pathogens, mostly from Aspergillus species. The infection has a spectrum of presenting features, and most patients are immunocompromised hosts, although immunocompetent subjects can also be affected. Usually patients presented a chronic soft exophytic mass with skin tenderness. Neuroimaging data are usually indicative of osteomyelitis but are not specific for cranial vault mycosis. However, the most significant finding for diagnosis should be made by histopathological examination and culture of specimens obtained at surgery. Fungal cranial vault infections are usually misdiagnosed and frequently considered only following failure of antibacterial therapy resulting in high rate of morbidity and intracranial complications. Systemic antifungal medications with or without surgery remain the cornerstone of management. High index of suspicion, early diagnosis, and aggressive surgical management if needed, followed by antifungal drugs, by an interdisciplinary team, may help to improve outcomes.
KeywordsAspergillosis Cranial osteomyelitis Cranial vault Cryptococcosis Fungal infections Mycosis Osteitis Scalp abscess
Cranial vault mycosis
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