Fungal infections of the brain are seen among immunocompromised individuals (transplant patients, HIV-infected patients, cancer patients undergoing chemotherapy, and hospitalized people with serious underlying diseases). The clinical signs are variable.
Based on morphology and mode of spore production, fungi are classified as yeasts (unicellular) or molds (multicellular organisms). The most common infectious agents include Aspergillus spp., Cryptococcus neoformans, Histoplasma capsulatum, and Candida ssp. In general, multiple parenchymal lesions with variable parenchymal and leptomeningeal enhancement are detected using radiologic imaging techniques. With the use of special stains (Gomori methenamine silver, Grocott, perjodic acid-Schiff, mucicarmine, Gram stain, and Giemsa stain) the agents can be visualized and their morphology (septation, branching, budding, hyphae) determined.
Treatment is performed with antifungal agents. Clinical outcome depends on the sanitation of the primary focus and the state of immunodeficiency or immunocompetence.
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