Spectrum of central nervous system mycoses and antifungal susceptibility: a two-year retrospective analysis from a tertiary care hospital in India

Sukanya  Sudhaharan; Umabala  Pamidimukkala; Shivani  Bojja; Nikhil  Gandi; Vamsi Krishna  Yerramneni; Sireesha  Yareeda

doi:10.18502/ijm.v18i3.21668

Sukanya Sudhaharan Department of Microbiology, ICMR-Advanced Mycology Diagnostic and Research Centre, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India
Umabala Pamidimukkala Department of Microbiology, ICMR-Advanced Mycology Diagnostic and Research Centre, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India
Shivani Bojja Department of Microbiology, ICMR-Advanced Mycology Diagnostic and Research Centre, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India
Nikhil Gandi Department of Microbiology, ICMR-Advanced Mycology Diagnostic and Research Centre, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India
Vamsi Krishna Yerramneni Department of Neurosurgery, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India
Sireesha Yareeda Department of Neurology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India

DOI: https://doi.org/10.18502/ijm.v18i3.21668

Keywords: Brain abscesses; Meningitis; Ventriculoperitoneal shunts; Cladophialophora bantiana; Scedosporium apiosper- mum; Chaetomium lucknowensis

Abstract

Background and Objectives: The frequency of central nervous system (CNS) fungal infections is rising, leading to in- creased mortality. These infections pose diagnostic challenges, and therapy depends on the specific fungal pathogen identi- fied. Only a few studies from India have examined the spectrum of fungal pathogens causing CNS infections. The objective of this study was to analyze the clinical and microbiological diversity of fungal pathogens responsible for CNS infections.

Materials and Methods: This was a retrospective study conducted at a tertiary care center in India from January 2023 to December 2024. The study included patients in whom fungi were isolated from cerebrospinal fluid, brain abscess pus, and paraspinal abscesses.

Results: Nine fungal pathogens were identified during the study period. Three isolates were yeasts and six were molds. Brain abscess was the predominant clinical presentation. The yeast isolates included Cryptococcus neoformans (n = 1) in menin- gitis and Candida tropicalis (n = 1) and Candida parapsilosis (n = 1) in VP shunt infections. The molds isolated from brain abscesses included Cladophialophora bantiana (n = 1), Rhizopus arrhizus (n = 1), Aspergillus flavus (n = 2), Scedosporium apiospermum (n = 1), and Chaetomium lucknowensis (n = 1). Mortality was observed in 4 of 9 cases (44.4%).

Conclusion: In the present study, nine fungal pathogens were isolated over a two-year period from varied clinical presenta- tions. This highlights the rarity of the condition, which should not be overlooked