Fungal Infections of the Central Nervous System

Jia, Dan; Thakur, Kiran T.

doi:10.1055/s-0039-1688916

Cited by 15 publications

(11 citation statements)

References 152 publications

(184 reference statements)

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“…Despite of the impact of HIV/AIDS, malignancies or chronic poorly controlled medical conditions, such as diabetes mellitus, there are other important conditions that increase the risk of fungal infections, as genetic diseases, use of indwelling catheters and medications, especially to treat autoimmune disease, cancer or prevent transplant rejection. 18 …”

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confidence: 99%

“…Disorders in the phagocytic function, as neutropenia, predispose patients to the development of CNS aspergillosis, as well as impairment of cell-mediated immunity predisposes patients to CNS cryptococcal, histoplasmal, coccidioidal, and blastomycotic infection. 18 CNS infection by Candida sp, Aspergillus sp, and Zygomycetes is also frequently associated with impairment of granulocyte function. 18 …”

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confidence: 99%

“… 18 CNS infection by Candida sp, Aspergillus sp, and Zygomycetes is also frequently associated with impairment of granulocyte function. 18 …”

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confidence: 99%

“…Thus, it is thought that Aspergillus invades through hyphal expansion that causes endothelial destruction by this mechanism of immune evasion. 15 , 18 , 33 …”

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confidence: 99%

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Cerebrospinal fluid: a target of some fungi and an overview

Corrêa‐Moreira

Castro

Costa

et al. 2023

Mem. Inst. Oswaldo Cruz

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Meningitis is a potentially life-threatening infection characterised by the inflammation of the leptomeningeal membranes. The estimated annual prevalence of 8.7 million cases globally and the disease is caused by many different viral, bacterial, and fungal pathogens. Although several genera of fungi are capable of causing infections in the central nervous system (CNS), the most significant number of registered cases have, as causal agents, yeasts of the genus Cryptococcus . The relevance of cryptococcal meningitis has changed in the last decades, mainly due to the increase in the number of people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and medications that impair the immune responses. In this context, coronavirus disease 19 (COVID-19) has also emerged as a risk factor for invasive fungal infections (IFI), including fungal meningitis (FM), due to severe COVID-19 disease is associated with increased pro-inflammatory cytokines, interleukin (IL)-1, IL-6, and tumour necrosis factor-alpha, reduced CD4-interferon-gamma expression, CD4 and CD8 T cells. The gold standard technique for fungal identification is isolating fungi in the culture of the biological material, including cerebrospinal fluid (CSF). However, this methodology has as its main disadvantage the slow or null growth of some fungal species in culture, which makes it difficult to finalise the diagnosis. In conclusions, this article, in the first place, point that it is necessary to accurately identify the etiological agent in order to assist in the choice of the therapeutic regimen for the patients, including the implementation of actions that promote the reduction of the incidence, lethality, and fungal morbidity, which includes what is healthy in the CNS.

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Cerebrospinal fluid: a target of some fungi and an overview

Corrêa‐Moreira

Castro

Costa

et al. 2023

Mem. Inst. Oswaldo Cruz

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“…CNSI-related pathogens, which seriously affect the health of neurology and neurosurgical patients with high morbidity and mortality 5,6 . By virtue of the existence of the blood-brain barrier, CNSI is difficult to treat with antibiotics.…”

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Evaluation of a micro/nanofluidic chip platform for diagnosis of central nervous system infections: a multi-center prospective study

Zheng

Zhang

et al. 2020

Sci Rep

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Central nervous system infection (CNSI) is a significant type of infection that plagues the fields of neurology and neurosurgical science. Prompt and accurate diagnosis of CNSI is a major challenge in clinical and laboratory assessments; however, developing new methods may help improve diagnostic protocols. This study evaluated the second-generation micro/nanofluidic chip platform (MNCP-II), which overcomes the difficulties of diagnosing bacterial and fungal infections in the CNS. The MNCP-II is simple to operate, and can identify 44 genus or species targets and 35 genetic resistance determinants in 50 minutes. To evaluate the diagnostic accuracy of the second-generation micro/nanofluidic chip platform for CNSI in a multicenter study. The limit of detection (LOD) using the second-generation micro/nanofluidic chip platform was first determined using six different microbial standards. A total of 180 bacterium/fungi-containing cerebrospinal fluid (CSF) cultures and 26 CSF samples collected from CNSI patients with negative microbial cultures were evaluated using the MNCP-II platform for the identification of microorganism and determinants of genetic resistance. The results were compared to those obtained with conventional identification and antimicrobial susceptibility testing methods. The LOD of the various microbes tested with the MNCP-II was found to be in the range of 250-500 copies of DNA. For the 180 CSF microbe-positive cultures, the concordance rate between the platform and the conventional identification method was 90.00%; eight species attained 100% consistency. In the detection of 9 kinds of antibiotic resistance genes, including carbapenemases, ESBLs, aminoglycoside, vancomycin-related genes, and mecA, concordance rates with the conventional antimicrobial susceptibility testing methods exceeded 80.00%. For carbapenemases and ESBLs-related genes, both the sensitivity and positive predictive values of the platform tests were high (>90.0%) and could fully meet the requirements of clinical diagnosis. MNCP-II is a very effective molecular detection platform that can assist in the diagnosis of CNSI and can significantly improve diagnostic efficiency.Central nervous system infection (CNSI) is a significant type of infection that currently plagues the fields of neurology and neurosurgery 1 . The primary symptoms of CNSI are meningitis and encephalitis syndrome. Common pathogens that cause CNSI include various species of bacteria, fungi, and viruses 2 , and some insects have been identified as vectors for CNSI-associated pathogens 3,4 . Of them, bacteria and fungi are the most significant Additionally, the MNCP-II-A test was performed on 26 CSF microbial culture-negative specimens, and the specimens were subjected to Sanger sequencing to compare the consistency of the test results.AST of bacteria of MNCP-II. ASTs of all microbes isolated from the CSF positive broth was performed in the clinical diagnosis departments of each of the four neurological centers by applying a standardized protocol. All of the isolates w...

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