Publication: Imaging of CNS Fungal Infections: Review Article
Issued Date
2021-05-01
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ISSN
01252208
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2-s2.0-85106379792
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand. Vol.104, No.5 (2021), 872-885
Suggested Citation
Theeraphol Panyaping Imaging of CNS Fungal Infections: Review Article. Journal of the Medical Association of Thailand. Vol.104, No.5 (2021), 872-885. doi:10.35755/jmedassocthai.2021.05.12241 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78229
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Title
Imaging of CNS Fungal Infections: Review Article
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Abstract
Fungal infections of the central nervous system (CNS) are usually identified in immunocompromised patients but rare in immunocompetent hosts. The clinical and imaging manifestations are mainly influenced by types of fungal pathogen and immune status of the patients. The CNS fungal infections can develop through hematogenous dissemination from primary site of infection, cerebrospinal fluid seeding, or direct extension from adjacent sources of infection. Fungal infections can result in meningitis, meningoencephalitis, cerebritis, granuloma, or abscess formation, which imaging findings are often non-specific and difficult to distinguish from bacterial or tuberculous infection, non-infectious inflammatory disease, or even intracranial neoplasm. Vascular complications including vasculitis, cerebral infarction, or mycotic aneurysm are commonly present due to angioinvasion of fungal hyphae. In addition, some characteristic imaging features of fungal infections can be identified by computed tomography (CT) or magnetic resonance imaging (MRI), such as intracavitary projections in fungal abscesses and gelatinous pseudocysts in cryptococcosis that could help suggest the diagnosis. Recognizing the imaging findings of common intracranial fungal infections combined with appropriate clinical setting is crucial for allowing early diagnosis and leading to early specific treatment. The present article reviewed common imaging findings of CNS fungal infections and distinct imaging features of specific pathogens.