Abstract

Central nervous system infections due to Aspergillus spp and other hyaline molds such as Fusarium and Scedosporium spp are rare but fatal conditions. Invasion of the central nervous system (CNS) tends to occur as a result of hematogenous dissemination among immunocompromised patients, and by local extension or direct inoculation secondary to trauma in immunocompetent hosts. Efforts should be directed to confirm the diagnosis by image-guided stereotactic brain biopsy when feasible. Non-culture methods could be useful to support the diagnosis, but they have not been validated to be performed in cerebral spinal fluid. Treatment of these infections is challenging given the variable susceptibility profile of these pathogens and the penetration of antifungal agents into the brain.

Highlights

  • Invasive mold infections are a cause of increased morbidity and mortality among immunosuppressed patients [1]

  • This article presents an overview of the epidemiology, clinical presentation, diagnosis, and treatment of central nervous system (CNS) infections due to Aspergillus and other hyaline molds

  • Aspergillus fumigatus accounts for almost 90% of the infections in humans

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Summary

Introduction

Invasive mold infections are a cause of increased morbidity and mortality among immunosuppressed patients [1]. Fungal infections of the central nervous system (CNS) usually have devastating consequences. This is due in part to their often-non-specific presentation, delayed diagnosis, and limited treatment options. Neurosurgical procedures are not a therapeutic option due to the severity of patients’ underlying conditions and profound thrombocytopenia. This article presents an overview of the epidemiology, clinical presentation, diagnosis, and treatment of CNS infections due to Aspergillus and other hyaline molds

Aspergillus Species
Pathogenesis
Clinical Presentation and Outcome
Diagnosis
Treatment
Fusarium
Fusarium Species
Findings
Scedosporium Species
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