Pathology of fungal infection of the central nervous system 17 years experience from Southern India

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

1. C Sundaram¹,
2. P Umabala¹,
3. V Laxmi¹,
4. A K Purohit²,
5. V S S V Prasad²,
6. M Panigrahi²,
7. B P Sahu²,
8. M V Sarathi²,
9. S Kaul³,
10. R Borghain³,
11. A K Meena³,
12. S S Jayalakshmi³,
13. A Suvarna³,
14. S Mohandas³ and
15. J M K Murthy³

Article first published online: 15 SEP 2006

DOI: 10.1111/j.1365-2559.2006.02515.x

Issue

Histopathology

Volume 49, Issue 4, pages 396–405, October 2006

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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. and Murthy, J. M. K. (2006), Pathology of fungal infections of the central nervous system: 17 years' experience from Southern India. Histopathology, 49: 396–405. doi: 10.1111/j.1365-2559.2006.02515.x

Author Information

1. 1Departments of Pathology, Microbiology
2. 2Neurosurgery
3. 3Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India

^*Dr C Sundaram, Prof. & Head, Department of Pathology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad 500 082, India. e-mail: challa_sundaram@yahoo.com

Publication History

1. Issue published online: 15 SEP 2006
2. Article first published online: 15 SEP 2006
3. Date of submission 6 December 2005 Accepted for publication 21 February 2006

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Keywords:

• aspergillus;
• central nervous system;
• fungal infections;
• immunocompetent;
• pathology;
• tropical climate

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.