Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2016; 26(01): 120-125
DOI: 10.4103/0971-3026.178360
Neuro

Multimodality imaging in cranial blastomycosis, a great mimicker: Case-based illustration with review of clinical and imaging findings

Puneet S Kochar
Department of Radiology, Division of Neuroradiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
,
Chinar O Lath
Department of Radiology, Division of Neuroradiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
,
Andrew P Klein
Department of Radiology, Division of Neuroradiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
,
John L Ulmer
Department of Radiology, Division of Neuroradiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
Also available at
  PDF Download Permissions and Reprints

Abstract

We describe the clinical, laboratory, and imaging data of three patients who are proven cases of blastomycosis with cranial involvement. In this review, we discuss the imaging features of cranial blastomycosis with relevant clinical case examples including computed tomography (CT), magnetic resonance imaging (MRI), and advanced MR imaging techniques like magnetic resonance spectroscopy (MRS) and MR perfusion. Literature is reviewed for modern-day diagnosis and treatment of this fatal intracranial infection, if not diagnosed promptly and managed effectively.

Keywords

Blastomycosis; - cranial - magnetic resonance imaging


Publication History

Article published online:
30 July 2021

© 2016. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Ostrow TD, Hudgins PA. Magnetic resonance imaging of intracranial fungal infections. Top Magn Reson Imaging 1994;6:22-31.
  • 2 Scott AD, Dhir A. Case of the month #175: Intracranial blastomycosis. Can Assoc Radiol J 2012;63:73-6.
  • 3 McKinnell JA, Pappas PG. Blastomycosis: New insights into diagnosis, prevention, and treatment. Clin Chest Med 2009;30:227-39, v.
  • 4 Fetter BF, Klintworth GK, Hendry WS. Mycoses of the Central Nervous System. Baltimore: Williams and Wilkins; 1967.
  • 5 Wheat J. Endemic mycoses in AIDS: A clinical review. Clin Microbiol Rev 1995;8:146-59.
  • 6 Bradsher RW, Chapman SW, Pappas PG. Blastomycosis. Infect Dis Clin North Am 2003;17:21-40, vii.
  • 7 Bariola JR, Perry P, Pappas PG, Proia L, Shealey W, Wright PW, et al. Blastomycosis of the central nervous system: A multicenter review of diagnosis and treatment in the modern era. Clin Infect Dis 2010;50:797-804.
  • 8 Munich SA, Johnson AK, Ahuja SK, Venizelos A, Byrne RW. Large cerebellar mass lesion: A rare intracranial manifestation of blastomycosis. Surg Neurol Int 2013;4:141.
  • 9 Ward BA, Parent AD, Raila F. Indications for the surgical management of central nervous system blastomycosis. Surg Neurol 1995;43:379-88.
  • 10 Jain KK, Mittal SK, Kumar S, Gupta RK. Imaging features of central nervous system fungal infections. Neurol India 2007;55:241-50.
  • 11 Akture E, Salamat S, Baskaya MK. Intracranial blastomycosis presenting as an enhancing cerebellopontine mass. Turk Neurosurg 2013;23:252-5.
  • 12 Wylen EL, Nanda A. Blastomyces dermatitidis occurring as an isolated cerebellar mass. Neurosurg Rev 1999;22:152-4.
  • 13 Kale H, Narlawar R, Maheswari S, Desai S, Kohli A. CNS blastomycosis, mimic of meningioma. Indian J Radiol Imaging 2002;12:483-4.
  • 14 Chander B, Deb P, Sarkar C, Garg A, Mehta VS, Sharma MC. Cerebral blastomycosis: A case report. Indian J Pathol Microbiol 2007;50:821-4.
  • 15 Kim SW, Kim MK, Oh SM, Park SH. Racemose cysticercosis in the cerebellar hemisphere. J Korean Neurosurg Soc 2010;48:59-61.
  • 16 Mohazab HR, Langer BG, Ramsey RG. Intracranial blastomycosis presenting as a suprasellar mass: MR findings. J Comput Assist Tomogr 1997;21:845-7.
  • 17 Luthra G, Parihar A, Nath K, Jaiswal S, Prasad KN, Husain N, et al. Comparative evaluation of fungal, tubercular, and pyogenic brain abscesses with conventional and diffusion MR imaging and proton MR spectroscopy. AJNR Am J Neuroradiol 2007;28:1332-8.
  • 18 Vachhani JA, Lee WC, Desanto JR, Tsung AJ. Magnetic resonance spectroscopy imaging characteristics of cerebral blastomycosis. Surg Neurol Int 2014;5:80.
  • 19 Siegal JA, Cacayorinb ED, Nassif AS, Rizk D, Galambos C, Levy B, et al. Cerebral mucormycosis: Proton MR spectroscopy and MR imaging. Magn Reson Imaging 2000;18:915-20.
  • 20 Chapman SW, Dismukes WE, Proia LA, Bradsher RW, Pappas PG, Threlkeld MG, et al. Clinical practice guidelines for the management of blastomycosis: 2008 update by the Infectious Diseases Society of America. Clin Infect Dis 2008;46:1801-12.
  • 21 Lutsar I, Roffey S, Troke P. Voriconazole concentrations in the cerebrospinal fluid and brain tissue of guinea pigs and immunocompromised patients. Clin Infect Dis 2003;37:728-32.