Fungal, Cryptococcus and Parasitic Meningoencephalitis

by Carlo Raj, MD

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    We're going to move into fungal now. Are you ready? Fungal. So let’s talk about this fungal meningoencephalitis. So here, we’ll get into an interesting dynamic, right? We have meninges. And what does encephalitis mean to you? Good. Brain parenchyma. Now, your most common patient who is susceptible to fungal as you’d expect anywhere up and down the body would be in an immunocompromised patient, right? For example, what if you have fungal infection of the esophagus? Boy, immunocompromised. What if you find oral thrush? You take a tongue depressor and you scrape of the white stuff off the tongue. Immunocompromised is what you’re thinking already. No exception here. Common organisms include Cryptococcus neoformans, Coccidioides, Candida, Mucor. Your focus, take a look, the letter C. Letter C. Cryptococcus, Coccidioides. You could have Aspergillus, you could have Histoplasma, you could have blasto, they’re all here, right? But your focus will be on the first two, please. Let’s talk about cryptococcal meningoencephalitis. So I'm only going to focus upon a few here, the ones that are more common. Most common, fungal infection of the CNS. Typically, who’s your patient? Immunocompromised. Do not confuse this with candida. Well, how is the patient breathing in or should I say, what’s the access point? Maybe inhalation of spores from soil or maybe your pigeon crap. In other words, your pigeon stool or excrement. So think about all the different places where pigeons love to play. Maybe you’re working in an office in which right outside your window, every morning, you are breathing in that lovely pigeon excrement. Or maybe you are what, living underneath a bridge because you feel like camping out, I’m joking. But a homeless person, underneath a tunnel or whatever, and then what happens? While, you sleep there, you might get pooped...

    About the Lecture

    The lecture Fungal, Cryptococcus and Parasitic Meningoencephalitis by Carlo Raj, MD is from the course CNS Infection—Clinical Neurology.

    Included Quiz Questions

    1. Patient with a recent kidney transplant.
    2. A patient who is a chronic hypertensive.
    3. Patient who works in ship building factory
    4. A patient who is a chronic smoker.
    5. A patient who works in a microbiology laboratory.
    1. Cryptococcus
    2. Histoplasma
    3. Aspergillus
    4. Candida
    5. Coccidiosis
    1. Hydrocephalus is a complication.
    2. Exposure to Turkey is a risk factor.
    3. MRI shows multiple solid masses.
    4. The disease can be treated with antibiotics.
    5. CSF shows high glucose and low protein.
    1. Demonstration of the organisms using India ink preparation.
    2. Demonstration of positive cryptococcal antigen.
    3. CSF shows lymphocytic pleocytosis.
    4. CSF shows low glucose and high protein.
    5. Clinical features are itself diagnostic.
    1. Cefotaxime
    2. Amphotericin B
    3. Fluconazole
    4. Flucytosine
    5. Consolidation therapy

    Author of lecture Fungal, Cryptococcus and Parasitic Meningoencephalitis

     Carlo Raj, MD

    Carlo Raj, MD

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