Zygomycotic invasion of the central nervous system

Tomoaki Sasaki1, Masayuki Mineta, Keigo Kobayashi

  • 1Department of Radiology, Asahikawa Red Cross Hospital, Akebono, Asahikawa, Japan. tomoaki3est@gmail.com

Insights

Zygomycosis, a fungal infection, can impact the central nervous system (CNS). This report details three cases where zygomycosis led to severe neurological issues, including stroke and bleeding, following surgery or transplantation.

Area of Science:

  • Mycology
  • Neurology
  • Infectious Diseases

Background:

  • Zygomycosis is a rare but severe opportunistic fungal infection.
  • Central nervous system (CNS) involvement in zygomycosis is uncommon and associated with high mortality.
  • Risk factors include immunosuppression and invasive procedures.

Observation:

  • Three cases of CNS zygomycosis are presented.
  • Two cases occurred post-neurosurgery; one case post-bone marrow transplantation for leukemia.
  • Patients presented with persistent fever and progressive neurological deficits.

Findings:

  • Cerebral infarction with hemorrhage was observed in all patients.
  • Histopathology revealed zygomycotic hyphae causing mycotic aneurysms, vasculitis, and venous occlusion.
  • Direct fungal invasion of CNS vasculature is the primary mechanism of injury.

Implications:

  • Early diagnosis and aggressive treatment are crucial for improving outcomes in CNS zygomycosis.
  • Fungal infections should be considered in immunocompromised patients with neurological symptoms.
  • Understanding the vascular complications is key to managing this devastating infection.

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