Pathology of fungal infections of the central nervous system: 17 years' experience from Southern India

• Published in: Histopathology Vol. 49; no. 4; pp. 396 - 405
• Main Authors: Sundaram, C, Umabala, P, Laxmi, V, Purohit, A K, Prasad, V S S V, Panigrahi, M, Sahu, B P, Sarathi, M V, Kaul, S, Borghain, R, Meena, A K, Jayalakshmi, S S, Suvarna, A, Mohandas, S, Murthy, J M K
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-10-2006; Blackwell
• Subjects: Adolescent; Adult; Aged; aspergillus; Biological and medical sciences; central nervous system; Central Nervous System Fungal Infections - epidemiology; Central Nervous System Fungal Infections - pathology; Child; Child, Preschool; Diabetes Mellitus - epidemiology; Diabetes Mellitus - microbiology; Diabetes Mellitus - pathology; Female; fungal infections; Humans; immunocompetent; India; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; pathology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Retrospective Studies; Risk Factors; tropical climate; Asia; India; Fungi; Infection; Aspergillus; Anatomic pathology; pathology; Mycosis; Central nervous system; immunocompetent; Fungi Imperfecti; Tropical climate; Thallophyta; fungal infections
• ISSN: 0309-0167; 1365-2559
• DOI: 10.1111/j.1365-2559.2006.02515.x

Aims:  To describe the pathology of central nervous system (CNS) fungal infections with particular reference to India.
Methods and results:  This was a retrospective study from 1988 to 2004 constituting 130 cases. The diagnosis was based on morphology of biopsy/autopsy material. These included aspergillosis (n = 73), zygomycosis (n = 40), cryptococcosis (n = 2), rhodotorulosis (n = 1), candidiasis (n = 5), maduramycosis (n = 1), pheohyphomycosis (n = 3) and mixed infections (n = 5). Predisposing risk factors were present in 49 (38%) patients only. The majority of the patients were immunocompetent. The commonest risk factor was diabetes mellitus, the commonest route of infection was from a contiguous site and the commonest pathology was granuloma. Culture positivity was seen in only 31%.
Conclusion:  Environmental factors in tropical countries such as India play a significant role in the pathogenesis of CNS fungal infections.