Successful treatment of combined Aspergillus and Cytomegalovirus abscess in brain and lung after liver transplant for toxic fulminant hepatitis

Invasive aspergillosis is one of the most important and fatal complications after liver transplant, especially in patients with involvement of the central nervous system. We present a case of a patient who developed cerebral and pulmonary aspergillosis, coinfected with cytomegalovirus, after liver transplant for toxic fulminant hepatitis. The patient was treated successfully with neurosurgical intervention and voriconazole. Voriconazole is considered more effective in cerebral aspergillosis than other antifungal agents due to the greater penetration into central nervous system and higher cerebrospinal fluid and brain tissue levels.