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Neurocandidiasis: a case report and consideration of the causes of restricted diffusion

David J Lin1, Ari Sacks, Jeanne Shen

  • 1Department of Radiology, Brigham and Women's Hospital, Boston, USA. David_Lin@hms.harvard.edu

Journal of Radiology Case Reports
|May 25, 2013
PubMed

Insights

Diffusion weighted MRI is key for acute stroke, but restricted diffusion has many causes. This case shows CNS candidiasis mimicking stroke, highlighting the need to consider fungal infections in brain imaging diagnoses.

Area of Science:

  • Neurology
  • Radiology
  • Infectious Diseases

Background:

  • Diffusion weighted magnetic resonance imaging (DW-MRI) is a primary tool for diagnosing acute stroke.
  • Restricted diffusion on DW-MRI has a broad differential diagnosis beyond ischemia.
  • Invasive fungal infections can present with varied imaging findings.

Observation:

  • A case of central nervous system (CNS) candidiasis was observed.
  • Radiographic findings included bilateral punctate areas of restricted diffusion.
  • These lesions were located in the basal ganglia.

Findings:

  • Central nervous system (CNS) candidiasis can manifest as restricted diffusion on magnetic resonance (MR) imaging.
  • The observed pattern mimicked acute ischemic stroke.
  • Bilateral punctate restricted diffusion in the basal ganglia was a key radiographic feature.

Implications:

  • The differential diagnosis for restricted diffusion on brain MR imaging should extend beyond acute stroke.
  • Invasive fungal infections, such as CNS candidiasis, must be considered in the differential diagnosis.
  • Accurate diagnosis of CNS candidiasis is crucial for timely and appropriate treatment, improving patient outcomes.
Keywords:
Basal GangliaCentral Nervous System CandidaDiffusion Weighted ImagingNeurocandidiasisRestricted Diffusion

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