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Abstract:
With the exception of Cryptococcus neoformans, fungi are rarely detected in cerebrospinal fluid obtained from patients having or suspected of having fungal meningitis. A review of the literature reveals that several fungi have been either isolated, observed, or both in cerebrospinal fluid specimens. These fungi include Acremonium species, Aspergillus amstelodami, A. flavus, A. fumigatus, A. oryzae, A. terreus, Blastomyces dermatitidis, Candida albicans, C. tropicalis, C. viswanathii, Coccidioides immitis, Cryptococcus albidus, C. neoformans, Histoplasma capsulatum, Paecilomyces variotii, Paracoccidioides brasiliensis, Pseudallescheria boydii, Schizophyllum species, and Sporothrix schenckii. Laboratory findings for cerebrospinal fluid specimens obtained from such patients and clinical presentations are summarized.
Insights
Fungi are seldom found in cerebrospinal fluid (CSF) for meningitis, except for Cryptococcus neoformans. This review details various fungi identified in CSF, aiding diagnosis of fungal meningitis.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Clinical Microbiology
Background:
- Fungal meningitis diagnosis often relies on non-culture-based methods due to low fungal detection rates in cerebrospinal fluid (CSF).
- Cryptococcus neoformans is the most commonly identified fungus in CSF, but other fungal species can also cause meningitis.
Purpose of the Study:
- To review and summarize the literature on fungal species isolated or observed in CSF specimens from patients with suspected or confirmed fungal meningitis.
- To highlight the diversity of fungi that can be detected in CSF and their clinical relevance.
Main Methods:
- Comprehensive literature search of scientific databases for studies reporting fungal detection in CSF.
- Compilation and categorization of identified fungal species and their associated laboratory findings and clinical presentations.
Main Results:
- A wide array of fungal species, beyond Cryptococcus neoformans, have been reported in CSF.
- Examples include Acremonium, Aspergillus, Blastomyces, Candida, Coccidioides, Histoplasma, Paecilomyces, Paracoccidioides, Pseudallescheria, Schizophyllum, and Sporothrix species.
- The review summarizes laboratory findings and clinical presentations associated with these fungal detections.
Conclusions:
- While Cryptococcus neoformans is predominant, a broader spectrum of fungi can be detected in CSF, necessitating awareness among clinicians and microbiologists.
- Accurate identification of fungi in CSF is crucial for timely diagnosis and appropriate management of fungal meningitis.
- Further research into sensitive diagnostic methods for non-cryptococcal fungal meningitis is warranted.