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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Synonyms
- Coccidioidomycosis, histoplasmosis, blastomycosis, candidiasis, aspergillosis, mucormycosis
Definitions
- Fungal infections of CNS are potentially lethal conditions that can involve meninges, brain, and spinal cord
- Common fungi causing CNS infection
- Yeasts: Candida and Cryptococcus
- Dimorphic fungi: Coccidioides, Histoplasma, Blastomyces
- Molds: Aspergillus and mucormycetes
- Coccidioidomycosis
- Sporadic, relatively common
- Histoplasmosis
- Common
- Blastomycosis
- Rare, sporadic, generally affects lungs/skin
- Invasive CNS fungal infections
- Patients usually immunocompromised
- Agents
- Hyphae: Aspergillosis, mucormycosis
- Pseudohyphae/yeast: Candidiasis
IMAGING
General Features
CT Findings
MR Findings
Angiographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Jackson NR et al: Central nervous system infections due to coccidioidomycosis. J Fungi (Basel). 5(3), 2019
- Góralska K et al: Neuroinfections caused by fungi. Infection. 46(4):443-59, 2018
- Schwartz S et al: Advances in the diagnosis and treatment of fungal infections of the CNS. Lancet Neurol. 17(4):362-72, 2018
- Orlowski HLP et al: Imaging spectrum of invasive fungal and fungal-like infections. Radiographics. 37(4):1119-34, 2017
- Murthy JM et al: Fungal infections of the central nervous system. Handb Clin Neurol. 121:1383-401, 2014
- Saini J et al: Intracranial infections: key neuroimaging findings. Semin Roentgenol. 49(1):86-98, 2014
- Starkey J et al: MRI of CNS fungal infections: review of aspergillosis to histoplasmosis and everything in between. Clin Neuroradiol. 24(3):217-30, 2014
- Lammering JC et al: Imaging spectrum of CNS coccidioidomycosis: prevalence and significance of concurrent brain and spinal disease. AJR Am J Roentgenol. 200(6):1334-46, 2013
- Mathur M et al: Fungal infections of the central nervous system. Neuroimaging Clin N Am. 22(4):609-32, 2012
- Tahin B et al: [Manifestations of systemic mycoses and related infections in the central nervous system.] Orv Hetil. 150(29):1367-74, 2009
- Berkeley JL et al: Fatal immune reconstitution inflammatory syndrome with human immunodeficiency virus infection and Candida meningitis: case report and review of the literature. J Neurovirol. 14(3):267-76, 2008
- Luthra G et al: Comparative evaluation of fungal, tubercular, and pyogenic brain abscesses with conventional and diffusion MR imaging and proton MR spectroscopy. AJNR Am J Neuroradiol. 28(7):1332-8, 2007
- Redmond A et al: Fungal infections of the central nervous system: a review of fungal pathogens and treatment. Neurol India. 55(3):251-9, 2007
- Zivković S: Neuroimaging and neurologic complications after organ transplantation. J Neuroimaging. 17(2):110-23, 2007
- da Rocha AJ et al: Granulomatous diseases of the central nervous system. Top Magn Reson Imaging. 16(2):155-87, 2005
- Gaviani P et al: Diffusion-weighted imaging of fungal cerebral infection. AJNR Am J Neuroradiol. 26(5):1115-21, 2005
- Komatsu H et al: Molecular diagnosis of cerebral aspergillosis by sequence analysis with panfungal polymerase chain reaction. J Pediatr Hematol Oncol. 26(1):40-4, 2004
- Revankar SG et al: Primary central nervous system phaeohyphomycosis: a review of 101 cases. Clin Infect Dis. 38(2):206-16, 2004
- Wong AM et al: Magnetic resonance imaging of carotid artery abnormalities in patients with sphenoid sinusitis. Neuroradiology. 46(1):54-9, 2004
- Bradsher RW et al: Blastomycosis. Infect Dis Clin North Am. 17(1):21-40, vii, 2003
- Brandt ME et al: Epidemiology, clinical manifestations, and therapy of infections caused by dematiaceous fungi. J Chemother. 15 Suppl 2:36-47, 2003
- Schelenz S et al: Candidaemia in a London teaching hospital: analysis of 128 cases over a 7-year period. Mycoses. 46(9-10):390-6, 2003
- Chowfin A et al: Recurrent blastomycosis of the central nervous system: case report and review. Clin Infect Dis. 30(6):969-71, 2000
- Erly WK et al: Disseminated coccidioidomycosis complicated by vasculitis: a cause of fatal subarachnoid hemorrhage in two cases. AJNR Am J Neuroradiol. 20(9):1605-8, 1999
- Lai PH et al: Disseminated miliary cerebral candidiasis. AJNR Am J Neuroradiol. 18(7):1303-6, 1997
- Desai SP et al: Disseminated CNS histoplasmosis. AJNR Am J Neuroradiol. 12(2):290-2, 1991
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Synonyms
- Coccidioidomycosis, histoplasmosis, blastomycosis, candidiasis, aspergillosis, mucormycosis
Definitions
- Fungal infections of CNS are potentially lethal conditions that can involve meninges, brain, and spinal cord
- Common fungi causing CNS infection
- Yeasts: Candida and Cryptococcus
- Dimorphic fungi: Coccidioides, Histoplasma, Blastomyces
- Molds: Aspergillus and mucormycetes
- Coccidioidomycosis
- Sporadic, relatively common
- Histoplasmosis
- Common
- Blastomycosis
- Rare, sporadic, generally affects lungs/skin
- Invasive CNS fungal infections
- Patients usually immunocompromised
- Agents
- Hyphae: Aspergillosis, mucormycosis
- Pseudohyphae/yeast: Candidiasis
IMAGING
General Features
CT Findings
MR Findings
Angiographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Jackson NR et al: Central nervous system infections due to coccidioidomycosis. J Fungi (Basel). 5(3), 2019
- Góralska K et al: Neuroinfections caused by fungi. Infection. 46(4):443-59, 2018
- Schwartz S et al: Advances in the diagnosis and treatment of fungal infections of the CNS. Lancet Neurol. 17(4):362-72, 2018
- Orlowski HLP et al: Imaging spectrum of invasive fungal and fungal-like infections. Radiographics. 37(4):1119-34, 2017
- Murthy JM et al: Fungal infections of the central nervous system. Handb Clin Neurol. 121:1383-401, 2014
- Saini J et al: Intracranial infections: key neuroimaging findings. Semin Roentgenol. 49(1):86-98, 2014
- Starkey J et al: MRI of CNS fungal infections: review of aspergillosis to histoplasmosis and everything in between. Clin Neuroradiol. 24(3):217-30, 2014
- Lammering JC et al: Imaging spectrum of CNS coccidioidomycosis: prevalence and significance of concurrent brain and spinal disease. AJR Am J Roentgenol. 200(6):1334-46, 2013
- Mathur M et al: Fungal infections of the central nervous system. Neuroimaging Clin N Am. 22(4):609-32, 2012
- Tahin B et al: [Manifestations of systemic mycoses and related infections in the central nervous system.] Orv Hetil. 150(29):1367-74, 2009
- Berkeley JL et al: Fatal immune reconstitution inflammatory syndrome with human immunodeficiency virus infection and Candida meningitis: case report and review of the literature. J Neurovirol. 14(3):267-76, 2008
- Luthra G et al: Comparative evaluation of fungal, tubercular, and pyogenic brain abscesses with conventional and diffusion MR imaging and proton MR spectroscopy. AJNR Am J Neuroradiol. 28(7):1332-8, 2007
- Redmond A et al: Fungal infections of the central nervous system: a review of fungal pathogens and treatment. Neurol India. 55(3):251-9, 2007
- Zivković S: Neuroimaging and neurologic complications after organ transplantation. J Neuroimaging. 17(2):110-23, 2007
- da Rocha AJ et al: Granulomatous diseases of the central nervous system. Top Magn Reson Imaging. 16(2):155-87, 2005
- Gaviani P et al: Diffusion-weighted imaging of fungal cerebral infection. AJNR Am J Neuroradiol. 26(5):1115-21, 2005
- Komatsu H et al: Molecular diagnosis of cerebral aspergillosis by sequence analysis with panfungal polymerase chain reaction. J Pediatr Hematol Oncol. 26(1):40-4, 2004
- Revankar SG et al: Primary central nervous system phaeohyphomycosis: a review of 101 cases. Clin Infect Dis. 38(2):206-16, 2004
- Wong AM et al: Magnetic resonance imaging of carotid artery abnormalities in patients with sphenoid sinusitis. Neuroradiology. 46(1):54-9, 2004
- Bradsher RW et al: Blastomycosis. Infect Dis Clin North Am. 17(1):21-40, vii, 2003
- Brandt ME et al: Epidemiology, clinical manifestations, and therapy of infections caused by dematiaceous fungi. J Chemother. 15 Suppl 2:36-47, 2003
- Schelenz S et al: Candidaemia in a London teaching hospital: analysis of 128 cases over a 7-year period. Mycoses. 46(9-10):390-6, 2003
- Chowfin A et al: Recurrent blastomycosis of the central nervous system: case report and review. Clin Infect Dis. 30(6):969-71, 2000
- Erly WK et al: Disseminated coccidioidomycosis complicated by vasculitis: a cause of fatal subarachnoid hemorrhage in two cases. AJNR Am J Neuroradiol. 20(9):1605-8, 1999
- Lai PH et al: Disseminated miliary cerebral candidiasis. AJNR Am J Neuroradiol. 18(7):1303-6, 1997
- Desai SP et al: Disseminated CNS histoplasmosis. AJNR Am J Neuroradiol. 12(2):290-2, 1991
