Introduction: CEREBRAL invasive ASPERGILLOSIS is a rare but potentially fatal condition, predominantly affecting immunocompromised individuals. It affects 10% - 15% of patients who have disseminated ASPERGILLOSIS. The distinctive ability of Aspergillus to break down elastin in the vessel wall makes it highly angioinvasive, resulting in a broad range of neurological complications. Case Presentation: We report the case of a 57-year-old female with poorly controlled diabetes mellitus and hypertension, who presented with right-sided hemiparesis and facial paresis. Initial imaging revealed small vessel disease and a midline hyperdensity extending into the paranasal sinuses (PNS), prompting further evaluation with magnetic resonance imaging (MRI) and paranasal computed tomography (CT), which demonstrated a mass-like lesion in the sphenoidal sinuses and an acute brainstem infarction. The patient's medical history and imaging findings led to the suspicion of an invasive fungal infection, confirmed by biopsy, which revealed ASPERGILLOSIS. The patient underwent endoscopic surgical debridement to reduce the fungal burden, followed by antifungal therapy. Amphotericin B was initially administered, but treatment was later switched to voriconazole, and the patient's neurological condition partially improved after treatment. Conclusions: This case highlights the importance of early diagnosis and appropriate management, including antifungal therapy and surgical debridement, to reduce mortality in CEREBRAL ASPERGILLOSIS. The successful outcome highlights the importance of maintaining a high index of suspicion in immunocompromised patients presenting with neurological symptoms, even in the absence of pulmonary involvement.

Presentation of an unusual case of CEREBRAL ASPERGILLOSIS in an immune competent patient who was treated successfully but symptoms and signs of a demyelinating process following initial recovery has been occurred. A 29-year-old male with focal seizure. Brain MRI revealed small multiple hemispheric and dural lesions. An open biopsy was conducted. Histological evaluation revealed hyphe-like structure in the necrotic area, within vessel walls, and lumina, suggestive aspergillusfumigatus . Furthermore, brancheal hyphae in potassium hydrxide15% and colonies on sabourud dextrose agar were observed. Based of the above findings the patient underwent anti fungal therapy. The patient recovered and continued a normal life however a follow up MRI was performed after 3 months from recovery. No significant abnormality was observed from the MRI procedure. One month later the patient developed signs and symptoms of spinal cord involvement which seemed to be the result of myelitis. A brain MR showed no abnormalities .Therefore it seemed reasonable to administer corticosteroid as a treatment for suspected active demyelinating process. During the above treatment, signs and symptoms of myelopathy disappeared and a whole spine MRI showed remarkable improvement.

Introduction: Polymyositis is an idiopathic inflammatory myopathy that mainly manifests itself with muscle weakness. Patients with polymyositis have a higher risk of developing infections and malignancies. We report concurrent pulmonary and CEREBRAL lesions in a polymyositis patient with many diagnostic challenges. Case Presentation: A 56-year-old woman complained of a productive cough and dyspnea from two weeks ago. Her symptoms gradually progressed until a sudden loss of consciousness occurred. She was a known case of polymyositis and was treated with oral prednisolone. Imaging revealed concurrentpulmonaryandCEREBRAL lesions. Initially, the patient underwent empirical therapy. However, the patient underwent a bronchoscopy because she did not respond to treatment. Specimens obtained from respiratory secretions revealed branched septate hyphae, and the culture was positive for Aspergillus fumigatus. She was diagnosed with invasive ASPERGILLOSIS, so we replaced the therapy with voriconazole. After three months, the lung lesions improved, but the number and extent of CEREBRAL lesions increased. Finally, after a stereotactic biopsy, the patient was diagnosed with astrocytoma and became a candidate for radiotherapy. Conclusions: Patients with polymyositis are prone to contracting opportunistic infections and malignancies. Both of them can mimic each other and present diagnostic challenges to physicians. Thus, they should think about them for early diagnosis and timely treatment.

Serum level of Galactomannan for Aspergillus was strongly positive (1.8 ng/ml). Invasive pulmonary ASPERGILLOSIS was suspected and itraconazole was replaced by voriconazole. Three days later, bronchoalveolar lavage sample revealed heavy growth of Aspergillus fumigatus. Brain CTscan showed no abnormality. Twelve days after antifungal therapy, the size of nodular lesions decreased significantly.

Birds are routinely exposed to this fungus and only rarely become pathogenic and the lower respiratory tract is most severely affected by inhalation rout. There have been some recent reports about respiratory ASPERGILLOSIS in ostrich (Kyoung 2001, Marks et al 1994). Aspergillus spp usually cause disease under condition of stress, immunosupression, and prolonged treatment with antibiotics or massive exposure to the microorganism. Clinical signs of ASPERGILLOSIS in ostriches are weight loss, lethargy and dyspnea (Kyoung 2001). Other less common forms of ASPERGILLOSIS in birds are encephalitis, ophthalmitis, osteomyelitis, dermatitis and systemic form (Fitzgerald & Moisan (1995). A fumigatus was isolated in some cases of respiratory ASPERGILLOSIS (Campbell (1986). It has been reported that ASPERGILLOSIS was observed in ostriches in the late 19th and early 20th centuries, but is relatively uncommon today (Terzich &. Vanhooser (1993). This is the first case report of ASPERGILLOSIS due to A ftnigatus in Iran. The ostriches of this report had received chloramphenicol and enrofloxacin for a long time (45 days) so these drugs may have been the cause of the pulmonary ASPERGILLOSIS.

Background: CEREBRAL Palsy (CP) is one of the common causes of medical malpractice complaints in the field of obstetrics and gynecology. When the term CEREBRAL palsy is mentioned, the first thought that comes to the mind of the public and some professionals is prolonged labor. However, prolonged labor itself is influenced by multiple causes and factors. Methods: An analysis of existing studies and literature reviews examining the causes and factors influencing Perinatal asphyxia. Findings: Perinatal asphyxia refers to inadequate oxygen or blood supply to the fetus or newborn around the time of birth. This condition can occur due to various factors such as prolonged labor, umbilical cord compression, sudden umbilical cord prolapse, placental abruption, uterine rupture, severe preeclampsia, eclampsia, or other issues affecting blood supply and oxygen delivery. Conclusion: Unforeseen circumstances, underlying or genetic problems, and individual anatomical variations may lead to situations where prevention is impossible. Precisely distinguishing the factors contributing to asphyxia depends on multiple factors requiring multi-disciplinary clinical and laboratory evaluations. Nevertheless, in some cases, the exact cause of CEREBRAL palsy may remain unknown or ambiguous.

Introduction and objective: Aspergillus and Mucor are found to cause life threatening infections. Though CEREBRAL ASPERGILLOSIS and mucormycosis are rare, the disease mortality rate is found to be predominant in patients with immune system being compromised. Because of the high mortality rate of this infection, early diagnosis and prompt initiation of treatment are crucial as effective treatment improves the overall management of diseases. The objective of the present study was to screen for a method in diagnosing CEREBRAL ASPERGILLOSIS and CEREBRALmucor-mycosis.Materials and methods: In the present study the antigens were effectively extracted from Aspergillus and Mucor, and then they were characterized using native polyacrylamide gel electrophoresis, sodium dodecyl sulfate polyacrylamide gel electrophoresis, and their diagnostic potential was evaluated by ELISA.Results: Among the bands visualized Aspergillus flavus showed four distinct bands, two bands in A. fumigatus but a diffused band was noticed with Mucor. Clinical analysis by ELISA conducted in 47 cerebro spinal fluid samples from patients suspected for chronic meningitis infection were found to be positive for antigens in 8.51%, 6.38% and 12.76% for A. flavus, A. fumigatus and Mucor, respectively.Conclusion: From the results, it was concluded that ELISA can be used as a sensitive and reproducible test for diagnosis of CEREBRAL ASPERGILLOSIS and mucormycosis.Significance and impact of the study: With regard to the study on the fungal antigen which infects the central nervous system and also understanding the importance of ELISA as a sensitive and reproducible diagnostic tool, early diagnosis of CEREBRAL ASPERGILLOSIS and mucormycosis is possible.

Introduction: Invasive fungal sinusitis is a potentially lethal infection inimmunocompromisedpatients, with a reported incidence of around 2%. Neutropenia due to aplastic anemia or secondary to chemotherapy is the main cause of acute invasive fungal sinusitis.Case Presentation: We present the case of a 6-month-old boy with hem ophagocytic syndrome. During the follow-up for fever and pancytopenia at the medical faculty hospital of Hacettepe University, Ankara, Turkey, the patient developed discoloration and black crusting of the nasal columella. Antifungal medical treatment and biopsy were recommended owing to the suspicion of invasive fungal infection. The premaxilla, nasal columella, and nasal cartilages were necrotic. Medical and surgical treatments were performed to prevent the spread of infection. After controlling the underlying immunosuppression, nasal reconstruction was advised.Conclusions: Invasive fungal sinonasal disease is a rare clinical phenomenon in immunocompromised patients. Although it is associated with high mortality rates, it can be successfully managed with a combination of surgical and medical treatments.