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

BACKGROUND AND

OBJECTIVES

The frequency of central nervous system (CNS) fungal infections is rising, leading to increased mortality. These infections pose diagnostic challenges, and therapy depends on the specific fungal pathogen identified. 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 meningitis 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 presentations. This highlights the rarity of the condition, which should not be overlooked.