BrainWaves #120 Fungal brain disease

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: September 13, 2018 In 2012, more than 13,000 Americans were inadvertently exposed to contaminated medical equipment, resulting in one of the largest fungal outbreaks in United States history. Despite rapid mobilization by the CDC and FDA, 751 patients died from complications of fungal brain infections. But this is more the exception than the rule when it comes to fungal infections of the central nervous system. This week on the BrainWaves podcast, we review the common (and uncommon) clinical, radiographic, and diagnostic features of fungal brain disease. Enjoy! Produced by James E Siegler. Music by Jahzzar, Swelling, The Insider, and Chris Zabriskie. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. REFERENCES Baddley JW, Salzman D, Pappas PG. Fungal brain abscess in transplant recipients: epidemiologic, microbiologic, and clinical features. Clin Transplant 2002;16(6):419-24. PMID 12437621 Benedict K, Park BJ. Invasive fungal infections after natural disasters. Emerg Infect Dis 2014;20(3):349-55. PMID 24565446 Brouwer MC, Tunkel AR, McKhann GM 2nd, van de Beek D. Brain abscess. N Engl J Med 2014;371(5):447-56. PMID 25075836 Kainer MA, Reagan DR, Nguyen DB, et al. Fungal infections associated with contaminated methylprednisolone in Tennessee. N Engl J Med 2012;367(23):2194-203. PMID 23131029 McCotter OZ, Smith RM, Westercamp M, et al. Update on multistate outbreak of fungal infections associated with contaminated methylprednisolone injections, 2012-2014. MMWR Morb Mortal Wkly Rep 2015;64(42):1200-1. PMID 26513534 Schwartz S, Kontoyiannis DP, Harrison T, Ruhnke M. Advances in the diagnosis and treatment of fungal infections of the CNS. Lancet Neurol 2018;17(4):362-72. PMID 29477506 Smith RM, Schaefer MK, Kainer MA, et al. Fungal infections associated with contaminated methylprednisolone injections. N Engl J Med 2013;369(17):1598-609. PMID 23252499 Wilson MR, O'Donovan BD, Gelfand Jmet al. Chronic meningitis investigated via metagenomic next-generation sequencing. JAMA Neurol 2018;75(8):947-55. PMID 29710329  We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.