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Modifying cerebral candidiasis by altering the infectious entry route

J C Parker, T J Cleary, T Monji

    Archives of Pathology & Laboratory Medicine
    |October 1, 1980
    PubMed
    Summary

    Transient candidemia in rats did not cause diffuse leptomeningitis, despite brain microabscesses. Meningitis occurred only when Candida albicans directly infected the meninges, highlighting rare routes of fungal brain infection.

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    Area of Science:

    • Neuroscience
    • Infectious Diseases
    • Mycology

    Background:

    • * Candidemia, a bloodstream fungal infection, can potentially spread to the central nervous system (CNS).
    • * The development of fungal meningitis from candidemia is considered rare.
    • * Understanding the pathways of fungal CNS invasion is crucial for effective treatment.

    Purpose of the Study:

    • * To investigate the pathological outcomes of transient candidemia in the rat brain.
    • * To differentiate between intraparenchymal fungal brain infection and fungal meningitis.
    • * To explore the conditions under which candidemia may lead to leptomeningitis.

    Main Methods:

    • * Healthy adult male Wistar rats were subjected to transient candidemia via internal carotid artery injection of Candida albicans.

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  • * A separate group of rats received direct injection of Candida albicans into the cisterna magna to establish a meningeal infection model.
  • * Brains and kidneys were examined for fungal presence, and histopathological analysis was performed on infected tissues.

    • Main Results:

    • * Transient candidemia resulted in widespread intraparenchymal microabscesses in the brain, but not diffuse leptomeningitis.
    • * Candida albicans was culturally confirmed in the brain and kidneys of rats with candidemia.
    • * Direct injection into the cisterna magna led to leptomeningitis characterized by inflammatory cells, confined to the meninges, with fungi only recovered from the CNS.

    Conclusions:

    • * Intraparenchymal microabscesses from transient candidemia do not typically progress to diffuse leptomeningitis.
    • * Fungal meningitis due to candidemia appears to necessitate a brain microabscess accessible to cerebrospinal fluid (CSF).
    • * This accessibility is a late-stage complication of cerebral candidiasis, explaining the rarity of meningitis.