Mold Infections of the Central Nervous System

• Published in: The New England journal of medicine Vol. 371; no. 2; pp. 150 - 160
• Main Authors: McCarthy, Matthew, Rosengart, Axel, Schuetz, Audrey N, Kontoyiannis, Dimitrios P, Walsh, Thomas J
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 10.07.2014
• Subjects: Antifungal Agents - therapeutic use; Antigens; Biological and medical sciences; Brain; Central nervous system; Central Nervous System Fungal Infections - diagnosis; Central Nervous System Fungal Infections - drug therapy; Central Nervous System Fungal Infections - immunology; Central Nervous System Fungal Infections - surgery; Early Diagnosis; Epidemiology; Fungi; General aspects; Human mycoses; Humans; Infections; Infectious diseases; Medical imaging; Medical sciences; Miscellaneous mycoses; Mold; Mycoses; Nervous system; NMR; Nuclear magnetic resonance; Sinuses; Thrombosis; Infection; Medicine; Mycosis; Aspergillosis; Central nervous system
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMra1216008

Molds are ubiquitous in soil, water, and decaying vegetation and can cause devastating infections that are difficult to treat. This review summarizes the epidemiologic profiles, clinical characteristics, and treatment of mold infections of the central nervous system. The recent outbreak of Exserohilum rostratum meningitis linked to epidural injections of methylprednisolone acetate has brought renewed attention to mold infections of the central nervous system (CNS). 1 Although uncommon, these infections are often devastating and difficult to treat. This focused review of the epidemiologic aspects, clinical characteristics, and treatment of mold infections of the CNS covers a group of common pathogens: aspergillus, fusarium, and scedosporium species, molds in the order Mucorales, and dematiaceous molds. Infections caused by these pathogen groups have distinctive epidemiologic profiles, clinical manifestations, microbiologic characteristics, and therapeutic implications, all of which clinicians should understand. Common Features Molds . . .