Their larger morphology precludes access to the meningeal microcirculation causing a more focal disease leading to cerebritis, abscess formation, or involvement of larger vessels resulting in vasculitis, vascular occlusion, cerebral infarctions, or formation of mycotic aneurysms. Aspergillus and fungi of the order Mucorales are the most common hyphae forms. The most common yeast pathogens are Cryptococcus and Candida, and as their small size allows them access to the microcirculation they can cause diffuse leptomeningitis or manifest as parenchymal granulomas or abscesses.

An aggressive diagnostic approach and timely initiation of antifungal therapy is imperative to reduce morbidity and mortality.īased on their morphology, fungi can be categorized as yeast (small, unicellular organisms) or hyphae (growth in branchlike colonies). Infections can develop via hematogenous dissemination from a distant focus such as lung, through direct implantation after trauma or secondary to the local extension from sinonasal, orbital, or spinal infections. Due to a growing number of organ transplants, chemotherapies, and human immunodeficiency virus infections, the incidence of susceptible hosts is increasing. Fungal infections of the central nervous system (CNS) are rare clinical entities and their development largely depends on the interplay between the host's immune system and fungal virulence factors.

Picktorial 3.0 review