Candida central nervous system infection after neurosurgery: a single-institution case series and literature review

Abstract Introduction Gynecologic malignancies are an increasingly common proportion of central nervous system metastatic disease. As genetic sequencing technology improves and becomes more accessible, mutations associated with CNS metastasis are easier to elucidate. The aims of this case series and systematic literature review are to describe the patient population with CNS metastatic disease from a gynecologic primary, and to investigate why the proportion of CNS metastasis from gynecologic malignancies is increasing. Ultimately, we hope to improve understanding of this subset of metastatic CNS malignancies and improve management strategies. Methods A literature review of articles describing patients from 1990–2020 who were diagnosed with CNS metastasis from a known gynecologic primary malignancy was performed. Demographics, cancer type, mutation characteristics, management for metastatic disease, progression free survival, number of CNS metastases, and location of metastatic disease were assessed. Inclusion criteria were age>18 years, diagnosis of primary ovarian, uterine, or cervical cancer with confirmed metastatic disease to the CNS, including brain parenchyma, leptomeninges, or intradural spinal cord or dural metastases. Exclusion criteria included pediatric population and bony metastases (e.g., bony spine metastases without evidence of meningeal/parenchymal invasion). Results Our review showed that patients with gynecological metastasis to the CNS generally have worse outcomes regarding overall survival, progression free survival, and quality of life than patients without CNS metastasis. Discussion Our results infer that the reported increase in incidence of CNS metastasis from gynecologic malignancies is a reflection of improvement of detection given advances in technology, improved patient follow up, and increased overall survival of patients with gynecologic malignancies. Further characterization of mutations from gynecologic malignancies associated with brain metastasis could result in development of more treatment options for patients in the future and help determine factors that contribute to developing metastasis to the CNS of various degrees, thus, potentially inform treatment strategies.

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Anti-NMDAR encephalitis preceded by non-herpetic central nervous system infection: Systematic literature review and first case of tick-borne encephalitis triggering anti-NMDAR encephalitis

Journal of Neuroimmunology ◽

10.1016/j.jneuroim.2019.03.011 ◽

2019 ◽

Vol 332 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Elena Cavaliere ◽

Margherita Nosadini ◽

Maria Federica Pelizza ◽

Giulia Ventura ◽

Irene Toldo ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Literature Review ◽

Systematic Literature Review ◽

Central Nervous System Infection ◽

Nmdar Encephalitis ◽

First Case ◽

Tick Borne Encephalitis

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Central Nervous System–Invading Eccrine Gland Carcinoma: A Clinicopathologic Case Series and Literature Review

World Neurosurgery ◽

10.1016/j.wneu.2020.01.111 ◽

2020 ◽

Vol 138 ◽

pp. e17-e25

Author(s):

Saksham Gupta ◽

Alexander F.C. Hulsbergen ◽

David J. Segar ◽

Blake M. Hauser ◽

Joshua D. Bernstock ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Literature Review ◽

Case Series ◽

Eccrine Gland ◽

Gland Carcinoma

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Partial Status Epilepticus with Paradoxical Protein-Cytologic Dissociation in Cerebrospinal Fluid

International Journal of Epilepsy ◽

10.1055/s-0040-1716432 ◽

2020 ◽

Author(s):

Neeraj Singh ◽

John J. Lansing ◽

Aparna Polavarapu

Keyword(s):

Central Nervous System ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Status Epilepticus ◽

Central Nervous System Infection ◽

Case Series ◽

Refractory Status Epilepticus ◽

Multiple Drug ◽

High Morbidity ◽

Drug Interventions

AbstractStatus epilepticus is associated with high morbidity and mortality, often requiring multiple drug interventions and intensive care monitoring. Etiology of status epilepticus plays a crucial role in the treatment, natural course and outcome of the patient, prompting extensive testing and imaging. For example, an important risk for status epilepticus in adults and children is the presence of an underlying viral or bacterial central nervous system infection, appropriate treatment of which can improve the outcome of the patient. We present three cases of new-onset refractory status epilepticus in women who did not have evidence of a central nervous system infection and had significantly elevated leukocytes compared to protein in the cerebrospinal fluid. This finding suggests an autoimmune etiology; however, standard autoimmune testing was unremarkable in all cases. This case series highlights the variability in presentation and clinical course in patients presenting with status epilepticus of unknown cause, and we discuss the importance of further research into appropriate and reliable diagnostic evaluations.

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Cryptococcal infections in children: retrospective study and review from Australia

Future Microbiology ◽

10.2217/fmb-2019-0215 ◽

2019 ◽

Vol 14 (18) ◽

pp. 1531-1544

Author(s):

Alice Grimshaw ◽

Pamela Palasanthiran ◽

Julie Huynh ◽

Ben Marais ◽

Sharon Chen ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Retrospective Study ◽

Acute Lymphoblastic Leukemia ◽

Literature Review ◽

Lymphoblastic Leukemia ◽

Central Nervous System Infection ◽

Significant Morbidity ◽

Neurological Sequelae ◽

Substantial Morbidity

Aim: Cryptococcosis causes significant morbidity and mortality worldwide, but pediatric data are limited. Methods: A retrospective literature review of Australian pediatric cryptococcosis and additional 10-year audit of cases from a large pediatric network. Results: 22 cases of cryptococcosis in children were identified via literature review: median age was 13.5 years (IQR 7.8–16 years), 18/22 (82%) had meningitis or central nervous system infection. Where outcome was reported, 11/18 (61%) died. Of six audit cases identified from 2008 to 2017, 5 (83%) had C. gattii disease and survived. One child with acute lymphoblastic leukemia and C. neoformans infection died. For survivors, persisting respiratory or neurological sequelae were reported in 4/6 cases (67%). Conclusion: Cryptococcosis is uncommon in Australian children, but is associated with substantial morbidity.

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Ependymomas arising outside of the central nervous system: A case series and literature review

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2017.10.026 ◽

2018 ◽

Vol 47 ◽

pp. 202-207 ◽

Cited By ~ 4

Author(s):

Shlomit Yust Katz ◽

David Cachia ◽

Carlos Kamiya-Matsuoka ◽

Adriana Olar ◽

Brett Theeler ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Literature Review ◽

Case Series ◽

System A ◽

The Central Nervous System

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Treatment of Burkitt's Like Lymphoma: A Single Institution Case Series

Blood ◽

10.1182/blood.v118.21.4962.4962 ◽

2011 ◽

Vol 118 (21) ◽

pp. 4962-4962

Author(s):

Vishal Ranpura ◽

Shilpan S. Shah

Keyword(s):

Central Nervous System ◽

Bone Marrow ◽

Nervous System ◽

Peripheral Blood ◽

Chemotherapy Regimen ◽

Conflicts Of Interest ◽

Case Series ◽

B Cell Lymphoma ◽

Response To Treatment ◽

Single Institution

Abstract Abstract 4962 Background: Burkits's like (BL) lymphoma is a new pathologic entity with features partially resembling to Burkitt's lymphoma and diffuse large B cell lymphoma. The incidence of BL lymphoma is infrequent and may present with lymph node enlargement, involvement of bone marrow and peripheral blood. The natural history of BL lymphoma and its treatment remains unclear. Here we present a single institution case series of five patients diagnosed with BL lymphoma and their treatment. Methods: We searched the pathology reports of all patients diagnosed with lymphoma over the last one year. No inclusion or exclusion criteria were used. Results: We identified a total of five patients with diagnosis of BL lymphoma. All patients presented with lymphadenopathy and with no involvement of bone marrow, central nervous system or peripheral blood. Table 1 summarizes characteristics of all patients, their chemotherapy regimen and subsequent response to treatment. Conclusion: BL lymphoma is a new pathologic entity with low incidence. Treatment with DA-EPOCH and R-HyperCVAD has very good response rate. The data is limited by single institution case series and limited follow up time. Further studies are recommended to evaluate optimal chemotherapy regimen. Table 1: Characteristics, presentation, treatment and response in patients with BL lymphoma No Age Sex LDH, Presentation Treatment Response Duration of response 1 68 F 386 Parotid and abdominal lymphadenopathy DA-R-EPOCH CR 16months 2^ 44 M 536 Neck, Axillary, media, abdomen pelvis and sacral mets R-HyperCVAD PR 3months 3* 66 F 310 Inguinal and pelvic lymphadenopathy R-HyperCVAD f/b Autologus BMT, CR 14months 4** 71 M 237 Parotid mass 3 cycles of DA-EPOCH f/b 3 cycles of R-CHOP CR 9months 5^ 52 M 186 Neck Lymphadenopathy R-HyperCVAD CR 3months DOX, DOXOL, and anthracenediones in soluble fractions of human myocardial strips after sequential DOX loading/clearance and anthracenedione treatment Notes: DA-REPOCH: Dose Adjusted Rituximab-Etoposide, Vincristine, Cyclophosphamide, Doxorubicine, Prednisone, R-HyperCVAD: Rituximab, hyperfractionated Cyclophosphamide, Vincristine, Doxorubicin, Dexamethasone, CR: complete remission, BMT: bone marrow transplantation, R-CHOP: rituximab, doxorubicin, cyclophosphamide, vincristine and prednisone. CNS: central nervous system * patient underwent bone marrow transplant because of relapse at current presentation. ** patient was changed from DA EPOCH to R-CHOP as patient was not able to tolerate EPOCH ^ Epatients are halfway through their treatment cycles and are actively getting treatment Disclosures: No relevant conflicts of interest to declare.

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