There are over 300 species of fungal pathogens that may cause disease in humans, and 10-15% of these could impact the CNS.3,7,17
There are various forms of CNS lesions that can occur as a manifestation of fungal infection. Some species, such as Candida, Cryptococcus, and Coccidioides enter the capillaries and subarachnoid spaces, causing meningitis and subpial ischaemic lesions. Candida also enters the blood vessels, resulting in local necrotic lesions, whilst Aspergillus and Mucoromycetes penetrate larger blood vessels, causing infarcts.3,18 Cerebro-rhino-orbital mucormycosis, caused by Mucorales, initially proliferates in the sinuses. It can then spread to the palate, orbit, and brain.18
Some of the most common presentations of CNS infection include meningitis, meningoencephalitis, and brain abscess.3