Related Experiment Video
Updated: May 2, 2026
Live Imaging of Antifungal Activity by Human Primary Neutrophils and Monocytes in Response to A. fumigatus
Published on: April 19, 2017
Fungal Intracranial Infections (Central Nervous System-Invasive Fungal Disease) in Patients With Haematological
Sohini Chattopadhyay1, Lydia Jennifer Sumanth2, Harshad Arvind Vanjare3
1Department of Hematology, Christian Medical College, Vellore, India.
Background:
Invasive fungal disease (IFD) is a sinister complication encountered in patients with haematological disorders. When occurring in the central nervous system (CNS), IFDs can have catastrophic outcomes.
Objectives:
To study the clinical presentation, predisposing etiological factors, and prognosis of a CNS-IFD in a patient with a haematological disorder.
Patients And Methods:
This is a retrospective study focusing on the clinical profile, diagnosis, treatment strategy and outcomes of 43 patients with an underlying haematological disorder, who were diagnosed with CNS-IFD between 2018 and 2022.
Results:
Of the 43 patients, 18 were chemotherapy recipients, while 23 were stem cell transplant (SCT) recipients and 2 presented with CNS-IFD at diagnosis. AML/MDS (37.2%) and ALL (18.6%) were the predominant underlying diagnoses. A sudden deterioration in sensorium (53.5%) was the earliest clinical sign, while T2 hyperintensities (26.8%), vascular involvement (26.8%) and ring-enhancing lesions (16.3%) were the commonest radiological findings, with all patients exhibiting diffusion restriction in diffusion-weighted images. Microbiological evidence of infection was obtained in all patients; however, culture positivity was established in only 25 patients. Rhizopus spp (23.2%) and Aspergillus spp (20.9%) were implicated in most cases. Overall survival of the cohort was 27.9% at a median follow-up of 6 months. In patients who succumbed, the median time to death was 4 days (0-46).
Conclusion:
CNS-IFD is associated with very poor survival in patients undergoing chemotherapy or an SCT, urging the need for prompt diagnosis and initiation of suitable antifungal therapy.
Insights
Central nervous system invasive fungal disease (CNS-IFD) is a severe complication in patients with hematological disorders, leading to poor outcomes. Prompt diagnosis and antifungal treatment are crucial for improving survival rates in these vulnerable patients.
Area of Science:
- Medical Mycology
- Hematology
- Infectious Diseases
- Neurology
Background:
- Invasive fungal diseases (IFDs) pose a significant threat to patients with hematological disorders.
- Central nervous system (CNS) involvement in IFDs can lead to devastating consequences.
Purpose of the Study:
- To investigate the clinical characteristics, etiological factors, and prognosis of CNS-IFD in patients with hematological conditions.
- To analyze the diagnostic approaches and treatment strategies for CNS-IFD in this patient population.
Main Methods:
- A retrospective study was conducted on 43 patients diagnosed with CNS-IFD between 2018 and 2022.
- Data collected included clinical presentation, underlying hematological diagnoses, radiological findings, microbiological results, treatment, and outcomes.
Main Results:
- The majority of patients were stem cell transplant (SCT) recipients (23) or chemotherapy recipients (18).
- Common clinical signs included sudden deterioration in sensorium (53.5%). Radiological findings revealed T2 hyperintensities and vascular involvement (26.8% each).
- Rhizopus spp. and Aspergillus spp. were the most frequent fungal pathogens. Overall survival was low at 27.9% with a median follow-up of 6 months.
Conclusions:
- CNS-IFD is associated with a very high mortality rate in patients undergoing chemotherapy or SCT.
- Urgent diagnosis and appropriate antifungal therapy are essential to improve patient survival.
