Histopathological study of candidal infection in the central nervous system.
In recent years, incidence of invasive fungal infection has been increasing, mostly due to advances in + medicine that may produce immunocompromised individuals. Candidial infection in the central nervous system (CNS) is one of the most serious forms of blood stream infection of Candida sp. and mortality is known to be more than 50%. In this research, we employed 27 autopsies with confirmed in vasive CNS yeast infection which were confirmed. In addition to detailed morphological analysis of yeast cells in lesions, in situ hybridization was carried out with an originally designed Candida-specific peptide nucleic acid (PNA) probe to identify the candidial infection of each patient. This was followed by histopathological investigation: invasiveness, shape, and distribution of yeast or yeasts with pseudohyphal growth, and a study regarding the correlation between histological characteristics and number of leukocytes in the peripheral blood just before death. Results showed that the, supratentorial region was the most common area of disseminated candidial infection in CNS, and that density was highest in the cerebral gray matter followed by the white matter and basal ganglia. On the other hand, regarding the lesions developed in the cortical area, the average distance from the brain surface was 4.026 mm. This area corresponding to the deeper cortex has a characteristic arterial structure that refers hairpin curving reverse. The structure may contribute to the high incidence of candidial foci in the deeper cortex, because of the increase in shear stress.
Nakayama
Haruo
H
2nd Department of Neurosurgery, Kinki University School of Medicine, Japan.
Shibuya
Kazutoshi
K
Kimura
Masatomo
M
Ueda
Morikazu
M
Iwabuchi
Satoshi
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000382:microbiology* / Q000473:pathology*; D001927:Brain Diseases / Q000382:microbiology* / Q000473:pathology*; D002176:Candida albicans / Q000302:isolation & purification*; D002177:Candidiasis / Q000382:microbiology* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D017403:In Situ Hybridization; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D055815:Young Adult