Central Nervous System Fungal Infection-Related Stroke: A Descriptive Study of Mold and Yeast-Associated Ischemic Stroke

George, Pravin; Ramiro, Joanna; Gomes, João; Newey, Christopher R.; Bhimraj, Adarsh

doi:10.1016/j.jstrokecerebrovasdis.2020.104759

Cited by 11 publications

(8 citation statements)

References 9 publications

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“…Fungal pathogens most commonly implicated in AIS include hyphae-forming moulds such as Aspergillus and Mucor species, as well as yeasts including Candida and Cryptococcus species [ 3 , 8 ]. These moulds are angioinvasive, increasing the likelihood of arterial thrombosis and embolism, in contrast to yeasts which may be more likely to cause multiple punctate strokes due to meningitis and effects on the microvascular circulation [ 3 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is important to maintain a high index of suspicion in order to identify patients with invasive fungal disease early. In patients who present with AIS, additional features suspicious for invasive fungal disease include fever, headache, risk factors (including immunocompromise, indwelling venous catheters or intravenous drug use) and unusual imaging findings such as a mediastinal mass or leptomeningeal enhancement (which may be seen in central nervous system yeast infection) [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…It usually affects immunocompromised hosts, in particular those with prolonged neutropenia, allogeneic haematopoietic stem cell transplant recipients, solid organ transplant recipients, advanced acquired immunodeficiency syndrome (AIDS) patients and those on high-dose corticosteroids. It rarely causes invasive disease in the immunocompetent and risk factors are poorly defined but likely include diabetes mellitus, intravenous drug use, and indwelling venous catheters [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Disseminated Aspergillosis with Mediastinal Invasion Causing Fatal Stroke in an Immunocompetent Young Man

Yarham,

Goh,

Raith

et al. 2024

Case Rep Neurol

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Introduction: Aspergillus flavus is a common cause of aspergillosis. Case Presentation: A previously fit and well, immunocompetent 27-year-old male living in Australia developed disseminated A. flavus complex infection with mediastinal and cardiac invasion, superior vena cava obstruction and stroke, with fatal haemorrhagic transformation. Conclusion: Aspergillus Flavus is a rare but important cause of serious disease in the immunocompetent.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Disseminated Aspergillosis with Mediastinal Invasion Causing Fatal Stroke in an Immunocompetent Young Man

Yarham,

Goh,

Raith

et al. 2024

Case Rep Neurol

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“…The bland infarcts may also evolve into secondary abscesses. The infarcts are commonly seen in anterior circulation [ 23 ]. However, we found infarcts in all territories.…”

Section: Discussionmentioning

confidence: 99%

MR vessel wall imaging in cerebral bacterial and fungal infections

et al. 2021

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Purpose Central nervous system (CNS) bacterial and fungal infections can cause secondary vasculitis which worsens the prognosis due to development of complications like infarctions or hemorrhages. In this prospective study, we aim to study intracranial vessel wall imaging findings in bacterial and fungal infections. Methods We included 12 cases of nontubercular bacterial and fungal CNS infections each, in whom definitive microbiological diagnosis could be made. High-resolution vessel wall imaging (VWI) and time of flight MR angiography (TOF MRA) were incorporated in the routine imaging protocol. All cases were evaluated for the presence of vascular enhancement, pattern of enhancement, and stenosis on VWI. Statistical analysis was done to evaluate association between findings of vessel wall imaging and infarctions. Results We found infarctions in 5 out of 12 cases (41.7%) of the bacterial group and 7 out of 12 cases (58.3%) of the fungal group. Vessel wall enhancement was seen in 5 cases (41.7%) of the bacterial group and 9 cases (75%) of the fungal group. There was a significant association between infarctions and vessel wall enhancement in the fungal group. However, pattern of enhancement or stenosis on VWI was not significantly associated with presence of infarction. VWI detected more cases of vascular involvement than TOF MRA. Conclusion Secondary infectious vasculitis in bacterial and fungal infections can be detected by VWI, which can play an important role in better patient management as detection of vascular involvement can prompt early treatment to prevent complications like infarctions or hemorrhages.

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“…The occurrence of ischemic stroke could cause widespread neuronal death due to insufficient blood perfusion, lack of oxygen and glucose for brain tissue metabolism, insufficient energy production, and local accumulation of some toxic metabolites, such as excitotoxic products, acid metabolites, oxidative stress products, and inflammatory mediators (1). In recent years, the incidence of ischemic stroke has gradually increased, affected by factors such as poor lifestyle and eating habits.…”

Section: Introductionmentioning

confidence: 99%

Relationship between the changes in thromboxane B2, 6-keto-prostaglandin Fla, and blood glucose levels and progressive ischemic stroke

Liu

Feng

et al. 2021

Ann Palliat Med

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Background: Progressive ischemic stroke is a common cerebrovascular disease with high morbidity.This study aimed to investigate the relationship between changes of Thromboxane B 2 (TXB 2 ), 6-ketoprostaglandin Fla (6-k-PGFla), and blood glucose (BG) levels with progressive ischemic stroke.Methods: A total of 106 patients with progressive ischemic stroke admitted to our hospital from December 2016 to December 2018 were recruited as the observation group, and 110 patients who received physical examination in our hospital during the same period were selected as the control group. The levels of TXB 2 , 6-k-PGFla, and BG in different groups were compared, the related risk factors affecting the prognosis of patients with progressive ischemic stroke were analyzed, and the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of TXB 2 , 6-k-PGFla, and BG for the prognostic mortality of patients with progressive ischemic stroke.Results: The levels of TXB 2 , 6-k-PGFla, and BG in the observation group were significantly higher than those in the control group (P<0.05). The prognostic mortality of participants with abnormally increased expression of TXB 2 , 6-k-PGFla, and BG was significantly higher than that of patients with normal expression of TXB 2 , 6-k-PGFla, and BG (P<0.05). Hypertension, diabetes, collateral circulatory disorders, hyperlipidemia, TXB 2 (abnormal increase), 6-k-PGFla (abnormal increase), and BG (abnormal increase) were risk factors affecting the prognosis of patients with progressive ischemic stroke (P<0.05). The area under the curve (AUC) of the ROC curve showed that TXB 2 , 6-k-PGFla, BG, and the combination of them were 0.846, 0.893, 0.835, and 0.971, respectively, showing that the AUC of the combination of them was the largest.Conclusions: Hypertension, diabetes, collateral circulatory disorders, hyperlipidemia, TXB 2 (abnormal increase), 6-k-PGFla (abnormal increase), and BG (abnormal increase) are risk factors affecting the prognosis of patients with progressive ischemic stroke. The combined detection of the 3 indicators showed high sensitivity and specificity in evaluating the prognostic mortality of patients with progressive ischemic stroke, indicating that clinicians might improve the early diagnosis rate of progressive ischemic stroke by combining the detection of TXB 2 , 6-k-PGFla, and BG to predict the prognosis of patients.

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Central Nervous System Fungal Infection-Related Stroke: A Descriptive Study of Mold and Yeast-Associated Ischemic Stroke

Cited by 11 publications

References 9 publications

Disseminated Aspergillosis with Mediastinal Invasion Causing Fatal Stroke in an Immunocompetent Young Man

Disseminated Aspergillosis with Mediastinal Invasion Causing Fatal Stroke in an Immunocompetent Young Man

MR vessel wall imaging in cerebral bacterial and fungal infections

Relationship between the changes in thromboxane B2, 6-keto-prostaglandin Fla, and blood glucose levels and progressive ischemic stroke

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