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CNS fungal infections

CNS fungal infections. Fungal infections. Cryptococcal meningitis (AIDS) Candida meningitis (neonates and neurosurgery) Brain abscesses. Cryptococcoal meningitis. Caused by one of two species: Cryptococcus neoformans Cryptococcus gattii

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CNS fungal infections

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  1. CNS fungal infections

  2. Fungal infections • Cryptococcal meningitis (AIDS) • Candida meningitis (neonates and neurosurgery) • Brain abscesses

  3. Cryptococcoal meningitis • Caused by one of two species: • Cryptococcus neoformans • Cryptococcus gattii • Acquired by inhalation of the basidiospore from the environment

  4. Cryptococcoal meningitis • AIDS defining opportunistic infection • Other increased risk populations include: • Lymphomas (e.g.Hodgkin's lymphoma) • Long-term corticosteroid therapy

  5. Diagnosis • Symptoms: Fever, fatigue, headache, neck stiffness, blurred vision and confusion • CSF examination and culture • India ink capsule staining • Detection of cryptococcal antigen (capsular material) • Capsulated yeast in culture Note: Candida species is not capsulated

  6. Fungal Brain infections • Apergillus species • Scedosporiumapiospermum • Zygomycetes • Candida species • Pigmented fungi: • Rhinocladiella mackenziei (Phaeohyphomycosis) • Cladophialophora(Phaeohyphomycosis) • Exophiala(Phaeohyphomycosis) • Fonsecaea (Phaeohyphomycosis)

  7. A case of Scedosporiumapiospermumbrain infection • A 51-year-old farmer had a near-drowning • Developed bronchopneumonia and treated with antibiotics • Two weeks later the patient developed bifrontal headache, with features suggestive of raised intracranial pressure. 

  8. Laboratory diagnosis Clinical material: • Aspirated pus • CSF • Tissue biopsies Direct Microscopy: • 10% KOH, H&E, PAS and Silver stain Culture: • SDA and BHIA

  9. Management • Surgical excision or drainage • Antifungal (Amphotericin B or Azoles)

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