ABSTRACT
Fungal infections of the central nervous system (CNS), once relatively rare, are now becoming increasingly common. This increased incidence is largely the result of a growing population of high-risk patients who are immunocompromised due to organ and hematopoietic stem cell transplantation, cancer chemotherapy, premature birth, and HIV/AIDS (Singh and Husain 2000, Scully et al. 2008). Although numerous fungal pathogens can infect the brain, the most common causes of fungal meningitis in the U.S.A. are Cryptococcus neoformans, Cryptococcus gattii, Coccidioides immitis, and Coccidioides posadasii (Jabbour et al. 1996, Singh et al. 1997, Jarvis and Harrison 2007, Satishchandra et al. 2007). Also, Candida spp., and Aspergillus spp. can infect the brain via hematogenous dissemination, while members of the Zygomycetes can invade the brain from direct extension from the nasal sinuses (Sanchez-Portocarrero et al. 2000, Kleinschmidt-DeMasters 2002, Marr et al. 2002). In South America, Paracoccidioides brasiliensis can infect the central nervous system. While fungal infections of the CNS are less common than bacterial infections, they are more diffi cult to treat, require prolonged antifungal therapy, and frequently result in neurologic sequelae and/or death. This review will focus on Cryptococcus neoformans and
1 Division of Infectious Diseases, Departments of Pediatrics and Surgery, Children’s Hospital Los Angeles and University of Southern California School of Medicine, Los Angeles, CA 90027.
