Fungal infections of the brain are uncommonly encountered clinical problems. However, even today the disease, its management and outcome involve significant morbidity and even fatal outcomes. This prompted us to analyze all such cases encountered by us at our institute, so as to derive information which could be of value in the future management of similar cases. At our institution, over the past 10 years we have had the opportunity to operate 38 patients with intracranial fungal masses. This of itself constitutes one of the largest single-institution series in the available literature. Twenty-eight of our patients were males, and 31 of the 38 were in the age-group 20-40 years. The location of the mass was basifrontal, and extending to the paranasal and ethmoid sinuses in 30 patients. In the remaining, the lesion involved base of the middle cranial fossa, or multiple brain lesions elsewhere. None of our patients had any clinical or lab evidence of immunosuppression. All the patients underwent surgical decompression of the lesions, with a philosophy of resecting as much as could safely be resected. The surgical treatment philosophy is further discussed. The preoperative and postoperative antifungal treatment was given to all patients. Postoperatively, 7 of our patients did not make a good recovery, and the responsible factors are discussed. Aspergillus species were the single commonest responsible agents, with other fungal species accounting for the remainder. To conclude, the outcome for patients with brain fungal masses continues to be suboptimal, and there is an urgent need for focus on various responsible factors relating to timely and accurate diagnosis, and appropriately radical medical and surgical treatment.
Full conference title:
The 15 th Congress of the International Society for Human and Animal Mycology
- ISHAM 15th (2003)