The clinical picture of fibular lesions is very diverse and reflects the whole spectrum of possible CNS lesions. The type of pathogen depends on the immune status of the patient. In individuals with normal immune status, cryptococcosis is most often detected, and in immunodeficiency states, candidiasis or aspergillosis. In third world countries, fungal diseases are more common than in Europe. Coccidioidosis, histoplasmosis are found in the Americas, and blastomycosis in America and Africa.
Cryptococci affect primarily all patients with AIDS, somatic diseases and other conditions characterized by impaired cellular immunity (with lymphomas, after organ transplantation or treatment with corticosteroids), less often with normal immune status. The primary infection in the sludge is the lungs. CNS disease occurs in acute or subacute form and is a combination of multifocal granulomatous encephalitis with meningitis, while symptoms of both meningitis and encephalitis may predominate.
Of the subjective symptoms , headache is most often encountered, which may be accompanied by symptoms of encephalitis such as personality changes, confusion, focal neurological disorders. In some cases, the only manifestation of the disease is] moderate cognitive deficit. In CSF, signs of chronic meningitis are detected, which in the case of immunodeficiency are minimal. When staining the preparation of CSF with mascara, cryptococci appear in half the cases, if this does not happen, the diagnosis can be confirmed by a test for antigens in the blood and CSF. In patients, Fiba growth is detected after 2-6 nsd. after sowing CSF. Sometimes it will also be possible to detect the growth of Fibo after sowing blood, saliva, urine or feces.
Amphotericin B and flucytosine are the means of choice . With immunodeficiency, prolonged use of flucytosine is recommended to prevent relapse. Candidiasis is rarely limited to central nervous system damage, most often representing a systemic fungal disease. In many cases, it is complicated by surgery on the internal organs, prolonged preservation of the venous catheter, treatment with corticosteroids, drug use, etc. The disease can occur in acute or chronic form, may or may not be accompanied by fever. Symptoms of meningitis or meningoencephalitis may be noted.
In the study of CSF, the usual picture of chronic meningitis is revealed. Occasionally, itosis reaches 2000 cells in 1 μl. The diagnosis is based on the detection of yeast in the study of CSF preparation or inoculation of CSF on appropriate media. Treatment consists of amphotericin B and flucytosine.