Abstract
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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Selected References
Almeida F, Wolf JM, Casadevall A (2015) Virulence-associated enzymes of cryptococcus neoformans. Eukaryot Cell 14(12):1173–1185. https://doi.org/10.1128/ec.00103-15
Ashdown BC, Tien RD, Felsberg GJ (1994) Aspergillosis of the brain and paranasal sinuses in immunocompromised patients: CT and MR imaging findings. AJR Am J Roentgenol 162(1):155–159. https://doi.org/10.2214/ajr.162.1.8273655
Brown SM, Campbell LT, Lodge JK (2007) Cryptococcus neoformans, a fungus under stress. Curr Opin Microbiol 10(4):320–325. https://doi.org/10.1016/j.mib.2007.05.014
Chai LY, Vonk AG, Kullberg BJ, Netea MG (2011) Immune response to Aspergillus fumigatus in compromised hosts: from bedside to bench. Future Microbiol 6(1):73–83. https://doi.org/10.2217/fmb.10.158
Cheng YC, Ling JF, Chang FC, Wang SJ, Fuh JL, Chen SS, Teng MM, Chang CY (2003) Radiological manifestations of cryptococcal infection in central nervous system. J Chin Med Assoc 66(1):19–26
Coelho C, Bocca AL, Casadevall A (2014a) The intracellular life of Cryptococcus neoformans. Annu Rev Pathol 9:219–238. https://doi.org/10.1146/annurev-pathol-012513-104653.
Coelho C, Bocca AL, Casadevall A (2014b) The tools for virulence of Cryptococcus neoformans. Adv Appl Microbiol 87:1–41. https://doi.org/10.1016/b978-0-12-800261-2.00001-3. 10.2217/fmb.14.132
da Silva Dantas A, Lee KK, Raziunaite I, Schaefer K, Wagener J, Yadav B, Gow NA (2016) Cell biology of Candida albicans-host interactions. Curr Opin Microbiol 34:111–118. https://doi.org/10.1016/j.mib.2016.08.006
Dagenais TR, Keller NP (2009) Pathogenesis of Aspergillus fumigatus in Invasive Aspergillosis. Clin Microbiol Rev 22(3):447–465. https://doi.org/10.1128/cmr.00055-08
DeLeon-Rodriguez CM, Casadevall A (2016) Cryptococcus neoformans: tripping on Acid in the Phagolysosome. Front Microbiol 7:164. https://doi.org/10.3389/fmicb.2016.00164
Ghazaei C (2017) Molecular insights into pathogenesis and infection with aspergillus fumigatus. Malays J Med Sci 24(1):10–20. https://doi.org/10.21315/mjms2017.24.1.2
Gibbons JG, Rokas A (2013) The function and evolution of the Aspergillus genome. Trends Microbiol 21(1):14–22. https://doi.org/10.1016/j.tim.2012.09.005
Goncalves SS, Souza AC, Chowdhary A, Meis JF, Colombo AL (2016) Epidemiology and molecular mechanisms of antifungal resistance in Candida and Aspergillus. Mycoses 59(4):198–219. https://doi.org/10.1111/myc.12469
Hall RA, Cottier F, Muhlschlegel FA (2009) Molecular networks in the fungal pathogen Candida albicans. Adv Appl Microbiol 67:191–212. https://doi.org/10.1016/s0065-2164(08)01006-x
Harrison TS (2000) Cryptococcus neoformans and cryptococcosis. J Infect 41(1):12–17. https://doi.org/10.1053/jinf.2000.0695
Hohl TM, Feldmesser M (2007) Aspergillus fumigatus: principles of pathogenesis and host defense. Eukaryot Cell 6(11):1953–1963. https://doi.org/10.1128/ec.00274-07
Hole C, Wormley FL Jr (2016) Innate host defenses against Cryptococcus neoformans. J Microbiol (Seoul, Korea) 54(3):202–211. https://doi.org/10.1007/s12275-016-5625-7
Jabra-Rizk MA, Kong EF, Tsui C, Nguyen MH, Clancy CJ, Fidel PL Jr, Noverr M (2016) Candida albicans pathogenesis: fitting within the host-microbe damage response framework. Infect Immun 84(10):2724–2739. https://doi.org/10.1128/iai.00469-16
Karkowska-Kuleta J, Rapala-Kozik M, Kozik A (2009) Fungi pathogenic to humans: molecular bases of virulence of Candida albicans, Cryptococcus neoformans and Aspergillus fumigatus. Acta Biochim Pol 56(2):211–224
Kim J, Sudbery P (2011) Candida albicans, a major human fungal pathogen. J Microbiol (Seoul, Korea) 49(2):171–177. https://doi.org/10.1007/s12275-011-1064-7
Lamoth F (2016) Aspergillus fumigatus-related species in clinical practice. Front Microbiol 7:683. https://doi.org/10.3389/fmicb.2016.00683
Lin X (2009) Cryptococcus neoformans: morphogenesis, infection, and evolution. Infect Genet Evol 9(4):401–416. https://doi.org/10.1016/j.meegid.2009.01.013
Lin X, Heitman J (2006) The biology of the Cryptococcus neoformans species complex. Annu Rev Microbiol 60:69–105. https://doi.org/10.1146/annurev.micro.60.080805.142102
Mayer FL, Wilson D, Hube B (2013) Candida albicans pathogenicity mechanisms. Virulence 4(2):119–128. https://doi.org/10.4161/viru.22913
Naglik JR, Richardson JP, Moyes DL (2014) Candida albicans pathogenicity and epithelial immunity. PLoS Pathog 10(8):e1004257. https://doi.org/10.1371/journal.ppat.1004257
Nobile CJ, Johnson AD (2015) Candida albicans biofilms and human disease. Annu Rev Microbiol 69:71–92. https://doi.org/10.1146/annurev-micro-091014-104330
Noble SM, Gianetti BA, Witchley JN (2017) Candida albicans cell-type switching and functional plasticity in the mammalian host. Nat Rev Microbiol 15(2):96–108. https://doi.org/10.1038/nrmicro.2016.157
O’Meara TR, Alspaugh JA (2012) The Cryptococcus neoformans capsule: a sword and a shield. Clin Microbiol Rev 25(3):387–408. https://doi.org/10.1128/cmr.00001-12
Perfect JR (2006) Cryptococcus neoformans: the yeast that likes it hot. FEMS Yeast Res 6(4):463–468. https://doi.org/10.1111/j.1567-1364.2006.00051.x
Poulain D (2015) Candida albicans, plasticity and pathogenesis. Crit Rev Microbiol 41(2):208–217. https://doi.org/10.3109/1040841x.2013.813904
Powers-Fletcher MV, Hanson KE (2016) Molecular diagnostic testing for Aspergillus. J Clin Microbiol 54(11):2655–2660. https://doi.org/10.1128/jcm.00818-16
Rohatgi S, Pirofski LA (2015) Host immunity to Cryptococcus neoformans. Future Microbiol 10(4):565–581. https://doi.org/10.2217/fmb.14.132.
Sabiiti W, May RC (2012) Mechanisms of infection by the human fungal pathogen Cryptococcus neoformans. Future Microbiol 7(11):1297–1313. https://doi.org/10.2217/fmb.12.102
Sellam A, Whiteway M (2016) Recent advances on Candida albicans biology and virulence. F1000Res 5:2582. https://doi.org/10.12688/f1000research.9617.1
Starkey J, Moritani T, Kirby P (2014) MRI of CNS fungal infections: review of aspergillosis to histoplasmosis and everything in between. Clin Neuroradiol 24(3):217–230. https://doi.org/10.1007/s00062-014-0305-7
Sugui JA, Kwon-Chung KJ, Juvvadi PR, Latge JP, Steinbach WJ (2014) Aspergillus fumigatus and related species. Cold Spring Harb Perspect Med 5(2):a019786. https://doi.org/10.1101/cshperspect.a019786
Tam JM, Mansour MK, Acharya M, Sokolovska A, Timmons AK, Lacy-Hulbert A, Vyas JM (2016) The role of autophagy-related proteins in Candida albicans infections. Pathogens (Basel, Switzerland) 5(2):E34. https://doi.org/10.3390/pathogens5020034
Zhang M, Sun D, Shi M (2015) Dancing cheek to cheek: Cryptococcus neoformans and phagocytes. Mycoses 4:410. https://doi.org/10.1186/s40064-015-1192-3. 10.1111/myc.12415
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer-Verlag GmbH Austria, part of Springer Nature
About this chapter
Cite this chapter
Weis, S. et al. (2019). Infections: Fungi. In: Imaging Brain Diseases. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1544-2_28
Download citation
DOI: https://doi.org/10.1007/978-3-7091-1544-2_28
Published:
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-1543-5
Online ISBN: 978-3-7091-1544-2
eBook Packages: MedicineMedicine (R0)