Aspergillosis of Central Nervous System (CNS) is a highly lethal infection in patients with leukemia and Stem Cell Transplantation (SCT). Case reports of CNS aspergillosis in patients with leukemia and SCT published between 1990 and August 2020 were gathered using a structured search through PubMed/Medline. Sixty-seven cases were identified over the searches of the PubMed bibliographic database and then, 59 cases were included in the final analysis. Europe had the largest share of cases at 57.6% (34 reports), followed by Americas and Asia. Affected patients were predominantly males (58.6%) and the mean age of the patients was 36.1 years, while 62.7% of the patients were under the age of 50 years. The most common leukemia types include Acute Lymphoblastic Leukemia (ALL), Chronic Lymphocytic Leukemia (CLL), and Acute Myeloid Leukemia (AML) at 43.4%, 27.4%, and 23.5%, respectively. Furthermore, stem cell transplantation was reported in 11 cases. The overall mortality was 33%; however, the attributable mortality rate of CNS aspergillosis was 24.5%. Altered mental status, hemiparesis, cranial nerve palsies, and seizures were the clearest manifestations of infection and lung involvement reported in 57% of the patients. Histopathologic examination led to the diagnosis of infection in 57% of the patients followed by culture (23.7%), galactomannan assay (8.5%), and molecular method (3.3%). Amphotericin B and voriconazole were the most frequently used drugs for infection treatment. Good results were not obtained in one-third of the patients treated by voriconazole. Finally, neurosurgical intervention was used for 23 patients (39%). CNS aspergillosis is a rapidly progressive infection in leukemic patients. Thus, these patients should be followed up more carefully. Furthermore, management of induction chemotherapy, use of different diagnostic methods, and use of appropriate antifungal can lead to infection control.

中文翻译：

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白血病和干细胞移植患者中枢神经系统曲霉病：病例报告的系统评价

中枢神经系统曲霉病 (CNS) 是白血病和干细胞移植 (SCT) 患者的一种高度致命的感染。1990 年至 2020 年 8 月间发表的白血病和 SCT 患者中枢神经系统曲霉病的病例报告是使用 PubMed/Medline 的结构化搜索收集的。通过 PubMed 书目数据库的搜索确定了 67 个案例，然后，59 个案例被纳入最终分析。欧洲的病例比例最大，为 57.6%（34 份报告），其次是美洲和亚洲。受影响的患者主要是男性（58.6%），患者的平均年龄为 36.1 岁，而 62.7% 的患者年龄在 50 岁以下。最常见的白血病类型包括 43.4% 的急性淋巴细胞白血病 (ALL)、慢性淋巴细胞白血病 (CLL) 和急性髓细胞白血病 (AML)，分别为 27.4% 和 23.5%。此外，11 例报告了干细胞移植。总死亡率为 33%；然而，CNS 曲霉病的归因死亡率为 24.5%。在 57% 的患者中报告的感染和肺部受累的最明显表现是精神状态改变、偏瘫、颅神经麻痹和癫痫发作。组织病理学检查导致 57% 的患者被诊断为感染，其次是培养 (23.7%)、半乳甘露聚糖测定 (8.5%) 和分子方法 (3.3%)。两性霉素B和伏立康唑是最常用的感染治疗药物。三分之一接受伏立康唑治疗的患者未获得良好结果。最后，对 23 名患者（39%）进行了神经外科干预。CNS 曲霉病是白血病患者中一种快速进展的感染。因此，应对这些患者进行更仔细的随访。此外，诱导化疗的管理、不同诊断方法的使用以及适当的抗真菌药物的使用可导致感染控制。