Articles for Doctors
Micóticas infections
of Nervous System
Central
NOTE: Translated
using software of
translation of
Spanish to English
Summary: Introduction: There has been an increased number of cases
of fungal diseases of the CNS during the past few years. This paper review current
literature about these conditions, with emphasis on recent advances on diagnosis and
therapy. Development: While some fungi may cause disease in normal hosts, most of
these microorganisms are opportunistics and affect immunocompromissed hosts. With the
exception of Candida albicans, that is a normal inhabitant of the intestinal tract,
most fungi enter the body by inhalation or through skin abrassions. Common fungal diseases
include aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, cryptococcosis,
histoplasmosis, mucormycosis, paracoccidiodomycosis, and phaeohyfomycosis. In general
terms, fungal invasion of the CNS may produce one or more of the following clinical
syndromes: subacute or chronic meningitis, encephalitis, parenchymal brain abscesses or
granulomas, stroke, or myelopathy. Diagnosis may be difficult on clinical grounds, and
data provided by neuroimaging studies or CSF examination is non-specific. Definitive
diagnosis usually rest on the demonstration of the causal agent on body fluids or tissue
samples. Early administration of amphotericin B, associated or not with the new azoles, is
indicated to arrest the often fatal course of these conditions. Conclusion:
Formerly considered rare diseses, the AIDS epidemic and the widespread use of
corticosteroids and citotoxic agents, have caused an increase in the prevalence of CNS
mycosis. Development of potent antimycotic drugs have improved the prognosis of fungal
diseases of the CNS. However, due to diagnostic delays or the presence of debilitating
conditions, some patients still have torpid clinical courses despite proper therapy
Author:
Ecuadorian
magazine of neurology
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