Central Nervous System Fungal Infections

1. A D E W I J A Y A , M D – M A R C H 2 0 2 3
Central Nervous System
Fungal Infections

2. Introduction
 Can be caused by a broad variety of fungi
 Typically occur in immunocompromised patients,
but can be in immunocompetent patients such as
inoculation during invasive procedures (eg,
neurosurgery) or after heavy exposure
 Diagnosis and treatment are challenging
 Frequently lethal
McCarthy M, Rosengart A, Schuetz AN, Kontoyiannis DP, Walsh TJ. Mold infections of the central nervous system. N Engl J Med 2014; 371: 150–60.
Liu Y, Feng M, Yao Y, et al. Cryptococcal meningitis after transnasal transsphenoidal pituitary microsurgery of ACTH-secreting pituitary adenoma: a case report. Medicine (Baltimore) 2017; 96:
e7124.
Stockamp NW, Thompson GR 3rd. Coccidioidomycosis. Infect Dis Clin North Am 2016; 30: 229–46

3. Clinical Syndromes
Abscess Infarction
Aneurysm Granuloma
Meningoencephalitis
Schwartz, S., Kontoyiannis, D. P., Harrison, T., & Ruhnke, M. (2018). Advances in the diagnosis and treatment of fungal infections of the CNS. The Lancet Neurology, 17(4), 362-372.

4. Etiology
Aspergillus sp.
Non-aspergillus Mould: mucomycetes
Cryptococcus Sp. (most common)
Candida Sp.
Non-candida & Non-cryptococcus
Dimorphic fungi
Schwartz, S., Kontoyiannis, D. P., Harrison, T., & Ruhnke, M. (2018). Advances in the diagnosis and treatment of fungal infections of the CNS. The Lancet Neurology, 17(4), 362-372.

5. Risk Factors
Schwartz, S., Kontoyiannis, D. P., Harrison, T., & Ruhnke, M. (2018). Advances in the diagnosis and treatment of fungal infections of the CNS. The Lancet Neurology, 17(4), 362-372.

6. Clinical Presentation
Schwartz, S., Kontoyiannis, D. P., Harrison, T., & Ruhnke, M. (2018). Advances in the diagnosis and treatment of fungal infections of the CNS. The Lancet Neurology, 17(4), 362-372.

7. Diagnosis & Treatment
Schwartz, S., Kontoyiannis, D. P., Harrison, T., & Ruhnke, M. (2018). Advances in the diagnosis and treatment of fungal infections of the CNS. The Lancet Neurology, 17(4), 362-372.

8. Summary
 More common in immunocompromised patients
 Difficult to treat and poor prognosis
 Early diagnosis and treatment are crucial

9. THANK YOU