Intradural extramedullary spinal candida infection

Merwick, Áine; Minhas, Z; Curtis, Carmel; Thom, Maria; Choi, David; Mummery, Catherine J.

doi:10.1136/practneurol-2014-001052

Cited by 8 publications

(3 citation statements)

References 13 publications

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“…The physiopathology of CNS candidiasis remains unclear: although the primary lesion may have been a fungal abscess, histopathological findings suggest an initial vasculitic mechanism, with fungal filaments found within vascular walls. A case of intradural but extramedullary Candida infection in a patient with parenteral nutrition has been described, 11 with end-arteritis obliterans causing medullary infarction, and Grocott staining showing yeasts and hyphae. Vasculitis lesions may be a route by which Candida can invade the CNS.…”

Section: Discussionmentioning

confidence: 99%

Pearls & Oy-sters: Spinal Cord Candidiasis Linked to CARD9 Deficiency Masquerading as a Longitudinally Extensive Transverse Myelitis

et al. 2022

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Candida spp. myelopathies are very rare. We report a case of subacute longitudinally extensive transverse myelitis in an apparently immunocompetent 55-year-old man. After a negative infectious workup, corticosteroids and plasma exchange were initiated. Although there was a transient initial improvement, symptoms then worsened, and the lumbar puncture was repeated. Candida albicans was isolated in the CSF, and a diagnosis of spinal cord candidiasis was made. Gene panel sequencing for inborn immune deficiencies identified a homozygous disease-causing CARD9 variant. Despite antifungal treatment, necrotic myelitis, meningoencephalitis, and cerebral vasculitis developed. Fungal spinal cord infections can mimic inflammatory myelitis, and beta-D-glucan testing of both serum and CSF may help narrow down the diagnosis. In cases of severe or unexpected invasive Candida spp. infection, even adults and apparently immunocompetent patients should be screened for inborn immune deficiencies and CARD9 deficiency in particular.

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Section: Discussionmentioning

confidence: 99%

Pearls & Oy-sters: Spinal Cord Candidiasis Linked to CARD9 Deficiency Masquerading as a Longitudinally Extensive Transverse Myelitis

et al. 2022

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“…In immunocompromised hosts or patients with chronic vascular access (e.g., dialysis catheters or parenteral nutrition), Candida species can cause a fungemia and subsequent osteomyelitis or abscess formation with compression or inflammation of the spinal cord and roots. 81 Cryptococcus species, most often seen in patients with compromised cell-mediated immunity and only recently identified in immunocompetent hosts, usually causes a meningitis or meningoencephalitis, but can in rare cases cause a vertebral osteomyelitis or transverse myelitis. 82 Treatment varies depending on the organism, host, and extent of disease.…”

Section: Fungimentioning

confidence: 99%

Infectious Myelopathies

Anand

2021

Semin Neurol

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In the setting of both globalization and increasing use of immunosuppressive therapy, infectious myelopathies are an important cause of morbidity worldwide. Clinical spinal cord syndromes related to infection are varied, including transverse myelitis, acute flaccid paralysis related to anterior horn cell involvement, spinal cord compression, chronic spastic paraparesis, and myeloradiculitis. Causative pathogens include viruses, parasites, pyogenic and atypical bacteria, and fungi. The epidemiology, clinical characteristics, diagnosis, and treatment of selected organisms will be discussed in this article.

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“…usually appears in the second or third place of frequency (Brumble et al 2017;Sundaram et al 2006). Meningitis is the most common clinical form of CNS involvement due to Candida spp., but chronic meningitis, brain abscess formation, ventriculitis, mycotic aneurysms, and vasculitis have also been reported (Zimmermann et al 2016;Merwick et al 2015;Fennelly et al 2013).…”

Section: 3mentioning

confidence: 99%

Histopathology

Jurado¹,

López-Panqueva²

2019

Fungal Infections of the Central Nervous System

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Candida spp. Drug-induced immunosuppression Corticosteroids Aspergillus spp., and other molds Biological drugs (TNFα inhibitors) Molds, dimorphic fungi, Cryptococcus spp. Immunomodulatory agents (e.g., ibrutinib) Aspergillus spp., Cryptococcus spp. Hematopoietic stem cell transplantation Aspergillus spp., non-Aspergillus molds Solid organ transplantation Candida spp., Aspergillus spp., non-Aspergillus molds Medical interventions Neurosurgery, spinal anesthesia, injection Aspergillus spp., other molds, Candida spp. Intravascular or intracranial devices Candida spp. Other Intravenous drug use Candida spp.

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Intradural extramedullary spinal candida infection

Cited by 8 publications

References 13 publications

Pearls & Oy-sters: Spinal Cord Candidiasis Linked to CARD9 Deficiency Masquerading as a Longitudinally Extensive Transverse Myelitis

Pearls & Oy-sters: Spinal Cord Candidiasis Linked to CARD9 Deficiency Masquerading as a Longitudinally Extensive Transverse Myelitis

Infectious Myelopathies

Histopathology

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