Cerebral Aspergillosis Caused by Neosartorya hiratsukae, Brazil
We report the first case of infection by Neosartorya hiratsukae, an ascomycete in which the conidial state resembles Aspergillus fumigatus. The fungus caused a brain infection in a Brazilian woman, who died despite itraconazole treatment. Diagnosis was established by direct microscopic examination, computed tomographic scan, and magnetic resonance imaging of the brain, and repeated cultures from the lesions. The in vitro antifungal susceptibility of the isolate is provided.

Aspergillus fumigatus is the most common filamentous fungus to cause opportunistic infections in humans. Two close relatives of A. fumigatus, classified in the ascomycetous genus Neosartorya, have been documented to cause occasional opportunistic infections. These species are N. fischeri and N. pseudofischeri. The former has been reported on two occasions as causing systemic infection in transplant recipients, as well as a mixed pulmonary infection in a patient with myeloma.N. pseudofischeri has been reported to cause different localized and invasive infections. The conidial states of these species are morphologically very similar to that of A. fumigatus.

We describe the first cerebral infection caused by another species of Neosartorya, N. hiratsukae. This taxon has been described only in Japan, where it was isolated from air and from pasteurized aloe juice.