Fungal and Parasitic Infections of the CNS - Inova Health System
Fungal and Parasitic Infections of the CNS - Inova Health System
Fungal and Parasitic Infections of the CNS - Inova Health System
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• Morphology:<br />
– Broad hyphae 10-15<br />
microns in diameter<br />
– Hyphae partially<br />
collapsed <strong>and</strong> distorted or<br />
twisted. Look almost<br />
artefactual on PAS, GMS<br />
– Folds may simulate<br />
septations<br />
– Branching irregular, in<br />
contrast to Aspergillus<br />
– Cross sections <strong>of</strong> large<br />
hyphae should not be<br />
mistaken for empty<br />
spherules <strong>of</strong> Coccidioides<br />
Zygomyces sp.<br />
Cryptococcus ne<strong>of</strong>ormans<br />
• Almost exclusively<br />
OPPORTUNISTIC infection<br />
in <strong>CNS</strong><br />
• Epidemiology: most<br />
common mycosis in AIDS<br />
patients; constitutes initial<br />
symptom <strong>of</strong> AIDS in up to<br />
26% <strong>of</strong> patients in older<br />
series<br />
• Severely<br />
immunocompromised<br />
patients: diffuse meningitis,<br />
with absent host<br />
inflammatory response<br />
• Localized infections<br />
(cryptococcomas) can be<br />
seen in some patients<br />
Cryptococcus ne<strong>of</strong>ormans<br />
• Almost exclusively<br />
OPPORTUNISTIC infection<br />
in <strong>CNS</strong><br />
• Epidemiology: most<br />
common mycosis in AIDS<br />
patients; constitutes initial<br />
symptom <strong>of</strong> AIDS in up to<br />
26% <strong>of</strong> patients in older<br />
series<br />
• Severely<br />
immunocompromised<br />
patients: diffuse meningitis,<br />
with absent host<br />
inflammatory response<br />
• Localized infections<br />
(cryptococcomas) can be<br />
seen in some patients<br />
15
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