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CNS Infections pp 119-137 | Cite as

Fungal Infection of the CNS

  • Mansa Amul Munshi
  • Antonella Rella
  • Maurizio Del PoetaEmail author
Chapter

Abstract

Fungal infections in the central nervous system have been known to lead to significant morbidity and mortality. Most of these infections are chronic and develop in patients with altered immune response. The most common predisposing factors for fungal CNS infections are HIV, organ transplant, tumors, prolonged antimicrobial therapy, chemotherapy, and long-term use of ventilators and catheters. The most common fungal pathogens are Cryptococcus spp., Candida albicans, Aspergillus spp., Histoplasma capsulatum, Coccidioides spp., and Zygomycetes. Occasionally there are serious outbreaks of rare fungal infections that affect also immunocompetent subjects, bringing to focus the enormity of unknown fungi that pose a threat to humans. The diagnosis is often difficult and the treatment options are limited. Hence, the prognosis of these infections is poor with high morbidity and high mortality. This chapter will discuss the most common fungal infections of the CNS and their challenges.

Keywords

Fungal infection Central nervous system Meningitis Cryptococcus neoformans Cerebrospinal fluid Amphotericin B Fluconazole 

Abbreviations

ABLC

Amphotericin B lipid complex

AIDS

Acquired immunodeficiency syndrome

AmB

Amphotericin B

AmBd

Amphotericin B deoxycholate

CNS

Central nervous system

CSF

Cerebrospinal fluid

CT

Computerized tomography scan

GMS stain

Gomori methenamine silver stain

HIV

Human immunodeficiency virus

LF-AmB

Lipid formulations of amphotericin B

MALDI-TOF

Matrix-assisted laser desorption ionization mass spectrometry-time of flight

NMR

Nuclear magnetic resonance

PAP stain

Papanicolaou stain

PAS stain

Periodic acid schiff stain

PCR

Polymerase chain reaction

Notes

Acknowledgments

This work was supported by National Institute of Health (NIH) awards AI56168, AI71142, AI87541, and AI100631 to MDP. Maurizio Del Poeta is a Burroughs Welcome New Investigator in the Pathogenesis of Infectious Diseases. The authors have no conflicts of interest that are directly relevant to the content of this review.

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Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  • Mansa Amul Munshi
    • 1
  • Antonella Rella
    • 1
  • Maurizio Del Poeta
    • 1
    Email author
  1. 1.Department of Molecular Genetics and MicrobiologyStony Brook UniversityStony BrookUSA

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