Metastatic Mycotic Abscesses of the Brain

Abstract

Fellow in Neurosurgery, Mayo Foundation ROCHESTER, MINN. METASTATIC mycotic infections of the brain are not common.At the Mayo Clinic, in a thirty-one year period (1915 through 1945), the lesions of 104 patients with metastatic brain abscesses were studied at necropsy. Brain abscesses due to mycotic organisms were found in only 5 of these cases. Candida (Monilia) albicans was found by culture to be the infecting organism in 1 of these cases. Coccidioides immitis was established histologically in 1 case reported by Beaver and Furrer1 in 1933. In the case reported by Craig and Dockerty2 in 1941 these authors were able to culture Coccidiodes immitis from the abscess. In the 2 remaining cases the infections were due to Actinomyces. In view of the fact that the clinical histories and pathologic findings in all these cases were so similar, only 2 of the cases will be reported subsequently in this paper.Infections and abscesses due to C. albicans are uncommon. A review of the literature shows that the organism has produced some serious lesions in a variety of anatomic locations. Cases of osteo¬ myelitis and infections of the joints have been

Cerebral candidiasis: case report of brain abscess secondary to Candida albicans, and review of literature

“…Therefore, the only definitive diagnostic procedure in patients with abscess or granuloma was surgical biopsy. In the four cases (including the present patient) in whom brain biopsy was performed, either by craniotomy or through trephine site, a specimen was obtained and the organism was identified as Candida albicans (Craig and Gates, 1949;Luyendijk, Welman, and Cormane, 1959;Vorreith et al, 1961).…”

“…Thirty-five patients had one or more antecedent conditions which increased their susceptibility to fungal infections, such as antibiotic therapy, adrenocortical steroid therapy, or severe debilitating illness. In seven patients, however, no demonstrable predisposing factor could be found to account for the central nervous system candidal infection (Miale, 1943;Zimmerman, Frutchey, and Gibbes, 1947;Craig and Gates, 1949;Parrillo, 1950;Levi and Rezza, 1950;Janke, 1957;Vorreith, Bares, Benes, and Vancunik, 1961). In the entire group of 42, there was a greater than 2 to 1 predominance of men.…”

From Mendel to mycoses: Immuno‐genomic warfare at the human–fungus interface

“…Indeed, based on the fulminant nature of AIC in the hematological oncology experience, it would be understandable to even question whether the entity of CIC actually exists. Yet, a fascinating series of sporadic reports unequivocally describes the occurrence of indolent central nervous system (CNS) infection with microbiologically documented Candida sp., in the absence of any overt immunosuppressive state or iatrogenesis 97–126 . A series of such reports were in people of French or French‐Canadian descent 127–135 .…”