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Fungal encephalitis following bone marrow transplantation: clinical findings and prognosis

Hag Teive1, A L M Carsten, F M Iwamoto

  • 1Neurology Service, Department of Internal Medicine, Hospital de Clínicas, Federal University of Paraná, Curitiba, Pr, Brazil. hagteive@mps.com.br

Journal of Postgraduate Medicine
|July 16, 2008
PubMed
Abstract

Insights

Fungal encephalitis (FE) is a severe complication after hematopoietic stem cell transplantation (HSCT), often leading to mortality. Identifying clinical patterns may enable earlier diagnosis and intervention for these central nervous system fungal infections.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Hematology

Background:

  • Central nervous system fungal infections (FI) are critical complications in hematopoietic stem cell transplantation (HSCT) recipients.
  • These infections contribute significantly to mortality in this vulnerable patient population.

Purpose of the Study:

  • To investigate the clinical characteristics of fungal encephalitis (FE).
  • To identify patterns associated with FE development in HSCT patients.

Main Methods:

  • Retrospective analysis of clinical records and autopsy reports.
  • Study conducted at the HSCT Center of the Hospital de Clínicas, Federal University of Paraná, Brazil.

Main Results:

  • Twelve HSCT patients diagnosed with fungal encephalitis presented with altered consciousness, hemiparesis, and seizures.
  • Two susceptibility subgroups identified: early-onset FI with severe leucopenia, and late-onset FI with graft-versus-host disease on immunosuppressants.
  • Eleven patients died from neurological complications, with post-mortem confirmation of FI.

Conclusions:

  • Recognizing clinical, paraclinical, and temporal patterns of FE is crucial.
  • These patterns offer potential for earlier diagnosis and timely interventions in HSCT patients.

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