Journal of
Infectious Diseases and Immunity

  • Abbreviation: J. Infect. Dis. Immun.
  • Language: English
  • ISSN: 2141-2375
  • DOI: 10.5897/JIDI
  • Start Year: 2009
  • Published Articles: 87

Review

Infections of the central nervous system by Candida

Natalia Aristizabal Henao1 and Basilio Vagner1,2*
1Universidad Pontificia Bolivariana, Medellin, Colombia. 2Pablo Tobon Uribe Hospital, Medellin, Colombia.
Email: [email protected]

  •  Accepted: 11 April 2011
  •  Published: 31 May 2011

Abstract

At present, the species of Candida are the increasing causes of infections in neutropenic and non neutropenic patients, and they enable the production of important morbimortality. Invasive candidiasis is the most frequent opportunistic mycosis and when there is central nervous system (CNS) involvement, mortality associated to mycosis increase. Unfortunately, studies based in autopsies prove that the prevalence of CNS disease by fungi is undervalued in clinical practice. The clinical presentation includes meningitis, microabscesses, macroabscesses, vascular and medullar injury. The initial symptoms of acute meningitis by Candida are indistinguishable from those produced by bacterial infection and its diagnosis requires a high level of suspicion in the cases of isolation of Candida in cerebrospinal fluid (CSF), in any sterile liquid in patients with pleocytosis in the CSF or in blood cultures and when there is no improvement of clinical condition in spite of proper treatment. Clinical evidence, although limited, suggests that the combination of antifungals produces faster CSF sterilization when compared to mono-therapy. Regrettably, in spite of appropriate treatment, the mortality associated with this entity is of 10 to 30% and the percentage of neurological sequels goes from 18 to 29% which highlights the importance of timely recognition and management of Candida related CNS infections.           

 

Key words: Candida, central nervous system infections.