Central nervous system fungal infections: Observations from a large tertiary hospital in northern India

Sethi, Prahlad K.; Khanna, Laxmi; Batra, Anuradha; Anand, Ish; Sethi, Nitin K.; Torgovnick, Josh; Arsura, Edward L.

doi:10.1016/j.clineuro.2012.03.007

Cited by 14 publications

(13 citation statements)

References 10 publications

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“…Multiple case reports have presented this Finally, other CNS opportunistic infections were encountered, such as mucormycosis in two cases (1% of total), which had a low percentage both in the total and in the fungal infection group when compared to other studies on fungal CNS infections [15]. Similarly, …”

Section: Moreover Another Important Reason For This Difference In Rementioning

confidence: 99%

Central nervous system infections at the Hospital Universitario de Santander: An autopsy study in the period of 2004–2015

Hernández¹,

Gómez‐Ochoa²,

Torra³

2017

APJTD

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Section: Moreover Another Important Reason For This Difference In Rementioning

confidence: 99%

Central nervous system infections at the Hospital Universitario de Santander: An autopsy study in the period of 2004–2015

Hernández¹,

Gómez‐Ochoa²,

Torra³

2017

APJTD

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“…For each proven or probable case, a detailed chart review was performed to identify patient characteristics including demographic data, signs and symptoms at presentation, immunosuppressed states (defined as a patient maintained on immunosuppressive therapies after solid organ or bone marrow transplant, AIDS with CD4 count <200 cells/ µL, chemotherapeutic agent use, high-dose steroids of ≥20 mg prednisone daily for ≥2 weeks, use of immunomodulators for other indications, and leukopenia). Risk factors for CNS fungal infection were also evaluated, including the presence of CNS hardware or recent CNS surgery, end-stage renal or hepatic disease, diabetes mellitus, total parenteral nutrition use, intravenous drug abuse, head trauma, residence in endemic areas, and long-term central line use [6].…”

Section: Case Datamentioning

confidence: 99%

Fungal Infections of the Central Nervous System: Clinical, Radiographic and Laboratory Manifestations

Brumble

Reza

Dhakal

et al. 2017

JMEN

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Objective: To assess the epidemiological aspects of central nervous system (CNS) fungal infections at 2 tertiary care teaching hospitals. Patients and methods:We conducted a retrospective electronic medical record review of clinical, radiographic, laboratory, and microbiological data from patients at Mayo Clinic (Rochester, MN and Jacksonville, FL) with a proven or probable diagnosis of a CNS fungal infection from January 1, 2000 to December 31, 2014. Results:We identified 97 (91 proven, 6 probable) CNS fungal infections; 73 had fungal meningitis, 18 had a tissue diagnosis, and 6 had CNS imaging indicative of infection with positive fungal cultures from other organs. Most patients (67%) were male with a median age of 60 years; 64% were immunosuppressed, 29%of whom received prednisone ≥20 mg daily for ≥2 weeks. Cryptococcus spp was the most frequent infection identified (57%) and headache (47%) was the most common presenting symptom. Survival was significantly worse for patients with CNS aspergillosis compared to those with CNS Cryptococcus spp (hazard ratio, 10.92; P<0.001).Conclusion: CNS fungal infections have increased in frequency, particularly in patients requiring immunosuppression; most infections are caused by Cryptococcus spp. Aspergillus spp. CNS infections had 100% mortality. High-dose prednisone was the most common cause of immunosuppression, and headache was the most frequent symptom at presentation.

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“…8 Fungal infections of the brain and meninges occur in both immunocompetent and immunocompromised hosts; the presentation may be cryptic and delay in diagnosis may result in poor function and even death. 9 The most common pathogens, from most common to least common, were mucormycosis, cryptococcus, and aspergillosis. 9 The diagnosis may be challenging because symptoms are nonspecific, the most common symptoms being headache, fevers, and decreased vision.…”

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confidence: 99%

“…9 The most common pathogens, from most common to least common, were mucormycosis, cryptococcus, and aspergillosis. 9 The diagnosis may be challenging because symptoms are nonspecific, the most common symptoms being headache, fevers, and decreased vision. While these infections are relatively uncommon, it is important for clinicians to be aware of them because they result in devastating morbidity and mortality; 28% of immunocompromised and 14% of immunocompetent patients died, even when appropriate treatments were rendered.…”

mentioning

confidence: 99%

“…While these infections are relatively uncommon, it is important for clinicians to be aware of them because they result in devastating morbidity and mortality; 28% of immunocompromised and 14% of immunocompetent patients died, even when appropriate treatments were rendered. 9 Hence, we emphasize the gravity of this disease and the need for prompt and accurate diagnosis.…”

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confidence: 99%

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Microbial DNA testing for inflammatory diseases of the brain of uncertain etiology

Takahashi

Mass²,

Hamilton

et al. 2014

Neur Clin Pract

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SummaryNeurologists may be confronted with patients who present with inflammatory brain lesions where the diagnosis cannot be made through history and physical examination alone. Molecular testing for bacterial infections, tuberculosis, and fungal infections may aid in the diagnosis. Since the treatments for these disorders are different and delays can result in permanent neurologic disability and death, rapid and accurate diagnoses are critical. This review provides the neurologist with testing options and recommends ways to enhance sensitivity and specificity. W e present a patient with an inflammatory brain lesion with unclear etiology. Universal bacterial PCR testing on a biopsy specimen allowed us to make the diagnosis of neurosyphilis. Case reportA 27-year-old woman presented to a local hospital with complaints of headache for 3 weeks and an episode of right upper extremity weakness lasting about an hour. The outside facility obtained a brain MRI, which revealed large, diffuse, confluent, T2 hyperintense signals in the frontal lobes (figure 1). There was rim and nodular gadolinium enhancement with sparing of the gray matter. Given this unusual MRI scan, the patient was transferred to our facility.

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Central nervous system fungal infections: Observations from a large tertiary hospital in northern India

Cited by 14 publications

References 10 publications

Central nervous system infections at the Hospital Universitario de Santander: An autopsy study in the period of 2004–2015

Central nervous system infections at the Hospital Universitario de Santander: An autopsy study in the period of 2004–2015

Fungal Infections of the Central Nervous System: Clinical, Radiographic and Laboratory Manifestations

Microbial DNA testing for inflammatory diseases of the brain of uncertain etiology

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