Fungal and Parasitic Infections of the CNS - Inova Health System

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An approach to CNS fungal infections Host immune status + Taxonomy simplified =pattern of disease + morphology* = workable classification schema * H&E, methenamine silver, periodic acid Schiff (PAS), mucicarmine, [IHC] Fungal CNS Infections-from P to O* 1. Blastomyces dermatitidis 2. Histoplasma capsulatum 3. Coccidioides immitis 4. Cladosporium trichoides 5. Aspergillus sp. + wannabees 6. Rhizopus sp. 7. Candida sp. + look-alikes *pathogenic to opportunistic Blastomyces dermatiditis • Usually a PATHOGENIC INFECTION • Epidemiology: predominantly in North America, esp. southeastern USA, lower Mississippi valley, and near southern end of Lake Michigan. Called “Chicago disease” 100 years ago • Even in endemic areas, incidence of infection is LOW (?under-reported due to lack of national statistics; disease only reportable in 3 states: Illinois, Wisconsin, Mississippi) • Incidence of CNS infection extremely LOW 4
Am J Surg Path 2007; 31:615-623 Blastomyces dermatidis Lung-only involvement is most common Blastomyces dermatidis Lung-only involvement is most common 5
Page 1 and 2: Fungal and Parasitic Infections of
Page 3: Taxonomy simplified for the rest of
Page 7 and 8: Uncommon, localized granuloma in CN
Page 9 and 10: Coccidioides immitis can be vasoinv
Page 11 and 12: Spectrum exists from bland infarcti
Page 13 and 14: Aspergillus look-alikes • Cannot
Page 15 and 16: • Morphology: - Broad hyphae 10-1
Page 17 and 18: Candida look-alikes • Torulopsis
Page 19 and 20: Nocardia and Actinomyces • Morpho
Page 21 and 22: CNS Metazoal infections: trematodes
Page 23 and 24: Lifecycle Adult tapeworm Cysticercu
Page 25 and 26: T1 Diagnosis Radiology • Scolex i
Page 27 and 28: Ameba • Entamoeba histolytica - S
Page 29 and 30: Balamuthia mandrillaris • Childre
Page 31: cysticercosis, toxoplasmosis, and t

Fungal and Parasitic Infections of the CNS - Inova Health System

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