Fungal encephalitis in human autopsy cases: severe neuronal injury, insufficient regeneration

Ref ID: 19183


S. Tauber, H. Eiffert, R. Lugert, S. Kellner, S. Bunkowski, S. Schütze, W. Brück, R. Nau

Author address:

Aachen, Göttingen, DE

Full conference title:

23rd European Congress of Clinical Microbiology and
Infectious Diseases

Date: 27 April 2014


Objectives: The present study aimed at examining neuronal injury and repair in postmortem brain sections of patients who died from fungal CNS infections.
Methods: Histological and immunohistochemical abnormalities in 15 autopsy cases with fungal CNS infections from 1990 to 2008 were compared to morphological findings in 10 age- und sex-matched control cases that died from acute non-neurological disorders. The fungal pathogens were identified by culture or PCR and morphology in postmortem brain tissue. Most patients with fungal encephalitis had either undergone an organ transplantation or suffered from a malignant hematological disorder; 5 out of 15 did not have a classical pre-disposing illness but suffered from severe septic infections as the principal cause of immunosuppression. In 2 cases alcoholism was documented.
Results: Fungal organisms detected were Aspergillus spp., Candida spp. and black yeast-like fungi including Cladosporium spp.. Histological analyses identified microglial activation, astrocytosis and axonal injury in the white matter without accompanying demyelination as typical features of this infectious disease. An increased rate of hippocampal neuronal apoptosis was detected in fungal encephalitis, while the number of recently generated TUC-4- and calretinin-expressing neurons in the dentate gyrus of the hippocampal formation did not differ between patients and controls.
Conclusions: Unlike in other infectious diseases of the nervous system such as bacterial meningitis and septic encephalitis, where a co-existence of damage and repair was observed, fungal encephalitis is characterized by strong damage and an insufficiency of neuronal regeneration.

Abstract Number: P1011

Conference Year: 2013

Link to conference website:

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