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Central nervous system fungal infections in tropics

N Khandelwal1, Vivek Gupta, Paramjeet Singh

  • 1Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India. khandelwaln@hotmail.com

Neuroimaging Clinics of North America
|October 29, 2011
PubMed

Insights

Central nervous system fungal infections present diverse neuroradiologic findings, often atypical due to minimal inflammation. Radiologists need high suspicion, especially in immunocompromised patients, to diagnose these infections.

Area of Science:

  • Neurology
  • Radiology
  • Infectious Diseases

Background:

  • Fungal infections of the central nervous system (CNS) encompass a spectrum from chronic to acute forms, leading to substantial morbidity and mortality.
  • These infections frequently exhibit atypical and variable neuroradiologic findings due to a lack of typical inflammatory responses.
  • A high index of suspicion is crucial for neuroradiologists, particularly in immunocompromised individuals, to consider CNS fungal infections.

Purpose of the Study:

  • To highlight the importance of recognizing diverse neuroradiologic manifestations of CNS fungal infections.
  • To emphasize the role of clinical features and imaging in identifying fungal pathogens.
  • To guide neuroradiologists in diagnosing fungal CNS infections, even in immunocompetent patients.

Main Methods:

  • Review of neuroradiologic findings in confirmed cases of CNS fungal infections.
  • Correlation of imaging features with clinical presentation and pathogen type.
  • Analysis of patterns of involvement, including hematogenous spread and direct sinonasal invasion.

Main Results:

  • CNS fungal infections display variable and often atypical imaging characteristics.
  • Immunocompromised status increases risk, but infections can occur in immunocompetent hosts.
  • Distinguishing between hematogenous and direct sinonasal patterns aids in etiological diagnosis.

Conclusions:

  • Neuroradiologists must maintain a high degree of suspicion for CNS fungal infections, considering various fungal appearances.
  • Identifying the pattern of involvement (hematogenous vs. direct) is key.
  • Integrating clinical information with imaging findings allows for informed speculation on the causative fungal pathogen.

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