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[A pathological study on cerebral mycosis]

F Abe, N Nakamura, Y Ommura

    No to Shinkei = Brain and Nerve
    |December 1, 1982
    PubMed
    Summary
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    Cerebral mycosis, fungal infections of the brain, occurred in 7 autopsy cases, often linked to underlying diseases and severe lymphocytopenia. Early diagnosis is crucial for patients with neurological symptoms and risk factors.

    Area of Science:

    • Neuropathology
    • Infectious Diseases
    • Medical Mycology

    Background:

    • Histopathological examination of autopsy cases from 1976-1981 identified cerebral mycosis.
    • Brain tissue analysis was conducted in 46% of 528 autopsy cases.
    • Cerebral mycosis cases were associated with underlying conditions like hematologic diseases, SLE, and myocardial infarction.

    Observation:

    • Seven cases of cerebral mycosis were histopathologically confirmed.
    • Common fungal culprits included Aspergillus, Candida, Mucor, and Cryptococcus.
    • Six cases were undiagnosed antemortem, highlighting diagnostic challenges.

    Findings:

    • Characteristic histopathological findings varied by fungal type: hemorrhagic/necrotic lesions (Aspergillus, Mucormycosis), abscesses/granulomas (Candida), and gelatinous leptomeningeal lesions (Cryptococcus).

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  • Severe lymphocytopenia (<500/mm3) was present in all but one case.
  • Most cerebral mycoses occurred with systemic fungal infections, except for one case of mucormycosis.

    • Implications:

    • Cerebral mycosis should be suspected in patients presenting with neurological symptoms, especially those with severe underlying diseases, indwelling deep venous lines, and lymphocytopenia.
    • Recognizing distinct histopathological patterns aids in diagnosing specific fungal brain infections.
    • Improved antemortem diagnosis of cerebral mycosis is critical for timely intervention and improved patient outcomes.