Fungal infections of the central nervous system: A review of fungal pathogens and treatment

Neurology India

Volumn 55, Issue 3, 2007, Pages 251-259

  Redmond, Andrew ^a,b   Dancer, Craig ^c   Woods, Marion ^b,d  

^a PRINCESS ALEXANDRA HOSPITAL   (Australia)

^b UNIVERSITY OF QUEENSLAND   (Australia)

^c Institute of Veterinary and Medical Science   (Australia)

^d ROYAL BRISBANE AND WOMEN'S HOSPITAL   (Australia)

Author keywords

Amphotericin B; Antifungals; Candida; Continuous infusion; Cryptococcus; Meningitis; Pharmacokinetics; Toxicity

Indexed keywords

AMPHOTERICIN B; AMPHOTERICIN B DEOXYCHOLATE; AMPHOTERICIN B LIPID COMPLEX; ANIDULAFUNGIN; CASPOFUNGIN; FLUCONAZOLE; FLUCYTOSINE; ITRACONAZOLE; KETOCONAZOLE; MICAFUNGIN; MICONAZOLE; POSACONAZOLE; RAVUCONAZOLE; TERBINAFINE; VORICONAZOLE;

ANTIBIOTIC SENSITIVITY; CANDIDA MENINGITIS; CANDIDEMIA; CONTINUOUS INFUSION; CRYPTOCOCCAL MENINGITIS; DISTRIBUTION VOLUME; DRUG ABSORPTION; DRUG BINDING; DRUG BIOAVAILABILITY; DRUG BLOOD LEVEL; DRUG CLEARANCE; DRUG COST; DRUG DISTRIBUTION; DRUG ELIMINATION; DRUG FORMULATION; DRUG HALF LIFE; DRUG MECHANISM; DRUG MEGADOSE; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; MAXIMUM PLASMA CONCENTRATION; MENINGITIS; MUCORMYCOSIS; NONHUMAN; REVIEW; SURGICAL TECHNIQUE;

EID: 35048839188     PISSN: 00283886     EISSN: None     Source Type: Journal    
DOI: 10.4103/0028-3886.35686     Document Type: Review

References (95)

1. Taylor EM. The impact of efflux transporters in the brain on the development of drugs for CNS disorders. Clin Pharmacokinet 2002;41:81-92.
2. Sager G. Cyclic GMP transporters. Neurochem Int 2004;45:865-73.
3. Balkis MM, Leidich SD, Mukherjee PK, Ghannoum MA. Mechanisms of fungal resistance: An overview. Drugs 2002;62:1025-40.
4. Ellis D. Amphotericin B: Spectrum and resistance. J Antimicrob Chemother 2002;49:7-10.
5. Hiemenz JW. Amphotericin B deoxycholate administered by continuous infusion: Does the dosage make a difference? Clin Infect Dis 2003;36:952-3.
6. Eriksson U, Seifert B, Schaffner A. Comparison of effects of amphotericin B deoxycholate infused over 4 or 24 hours: Randomized controlled trial. BMJ 2001;322:579-82.
7. Peleg AY, Woods ML. Continuous and 4 h infusion of amphotericin B: A comparative study involving high-risk haematology patients. J Antimicrob Chemother 2004;54:803-8.
8. Schneemann M, Bachli EB. Continuous infusion of amphotericin B deoxycholate: A cost-effective gold standard for therapy of invasive fungal infections? Clin Infect Dis 2004;38:303-4.
9. Imhof A, Walter RB, Schaffner A. Continuous infusion of escalated doses of amphotericin B deoxycholate: An open-label observational study. Clin Infect Dis 2003;36:943-51.
10. Spellberg B, Witt MD, Beck CK. Amphotericin B: Is a lipid-formulation gold standard feasible? Clin Infect Dis 2004;38:304-5.
11. Girmenia C, Cimino G, Di Cristofano F, Micozzi A, Gentile G, Martino P. Effects of hydration with salt repletion on renal toxicity of conventional amphotericin B empirical therapy: A prospective study in patients with hematological malignancies. Support Care Cancer 2005;13:987-92.
12. Wagner C, Graninger W, Presterl E, Joukhadar C. The echinocandins: Comparison of their pharmacokinetics, pharmacodynamics and clinical applications. Pharmacology 2006;78:161-77.
13. Bekersky I, Fielding RM, Dressler DE, Lee JW, Buell DN, Walsh TJ. Plasma protein binding of amphotericin B and pharmacokinetics of bound versus unbound amphotericin B after administration of intravenous liposomal amphotericin B (AmBisome) and amphotericin B deoxycholate. Antimicrob Agents Chemother 2002;46:834-40.
14. Lewis RE, Wiederhold NP. The solubility ceiling: A rationale for continuous infusion amphotericin B therapy? Clin Infect Dis 2003;37:871-2.
15. Bekersky I, Fielding RM, Dressler DE, Lee JW, Buell DN, Walsh TJ. Pharmacokinetics, excretion and mass balance of liposomal amphotericin B (AmBisome) and amphotericin B deoxycholate in humans. Antimicrob Agents Chemother 2002;46:828-33.
16. Lewis RE, Wiederhold NP, Prince RA, Kontoyiannis DP. In vitro pharmacodynamics of rapid versus continuous infusion of amphotericin B deoxycholate against Candida species in the presence of human serum albumin. J Antimicrob Chemother 2006;57:288-93.
17. Groll AH, Giri N, Petraitis V, Petraitiene R, Candelario M, Bacher JS, et al. Comparative efficacy and distribution of lipid formulations of amphotericin B in experimental Candida albicans infection of the central nervous system. J Infect Dis 2000;182:274-82.
18. Leenders AC, Reiss P, Portegies P, Clezy K, Hop WC, Hoy J, et al. Liposomal amphotericin B (AmBisome) compared with amphotericin B both followed by oral fluconazole in the treatment of AIDS-associated cryptococcal meningitis. AIDS 1997;11:1463-71.
19. Cornely OA, Maertens J, Bresnik M, Ebrahimi R, Ullmann AJ, Bouza E, et al. Liposomal amphotericin B as initial therapy for invasive mold infection: A randomized trial comparing a high-loading dose regimen with standard dosing (AmBiLoad trial). Clin Infect Dis 2007;44:1289-97.
20. Foulds G, Brennan DR, Wajszczuk C, Catanzaro A, Garg DC, Knopf W, et al. Fluconazole penetration into cerebrospinal fluid in humans. J Clin Pharmacol 1988;28:363-6.
21. Tucker RM, Williams PL, Arathoon EG, Levine BE, Hartstein AI, Hanson LH, et al. Pharmacokinetics of fluconazole in cerebrospinal fluid and serum in human coccidioidal meningitis. Antimicrob Agents Chemother 1988;32:369-73.
22. Perfect JR, Durack DT. Penetration of imidazoles and triazoles into cerebrospinal fluid of rabbits. J Antimicrob Chemother 1985;16:81-6.
23. Madu A, Cioffe C, Mian U, Burroughs M, Tuomanen E, Mayers M, et al. Pharmacokinetics of fluconazole in cerebrospinal fluid and serum of rabbits: Validation of an animal model used to measure drug concentrations in cerebrospinal fluid. Antimicrob Agents Chemother 1994;38:2111-5.
24. Prentice AG, Glasmacher A. Making sense of itraconazole pharmacokinetics. J Antimicrob Chemother 2005;56:i17-22.
25. Johnson LB, Kauffman CA. Voriconazole: A new triazole antifungal agent. Clin Infect Dis 2003;36:630-7.
26. Pearson MM, Rogers PD, Cleary JD, Chapman SW. Voriconazole: A new triazole antifungal agent. Ann Pharmacother 2003;37:420-32.
27. Schwartz S, Milatovic D, Thiel E. Successful treatment of cerebral aspergillosis with a novel triazole (voriconazole) in a patient with acute leukaemia. Br J Haematol 1997;97:663-5.
28. Verweij PE, Brinkman K, Kremer HP, Kullberg BJ, Meis JF. Aspergillus meningitis: diagnosis by non-culture-based microbiological methods and management. J Clin Microbiol 1999;37:1186-9.
29. Poza G, Montoya J, Redondo C, Ruiz J, Vila N, Rodriguez-Tudela JL, et al. Meningitis caused by Pseudallescheria boydii treated with voriconazole. Clin Infect Dis 2000;30:981-2.
30. Lutsar I, Roffey S, Troke P. Voriconazole concentrations in the cerebrospinal fluid and brain tissue of guinea pigs and immunocompromized patients. Clin Infect Dis 2003;37:728-32.
31. Elter T, Sieniawski M, Gossmann A, Wickenhauser C, Schröder U, Seifert H, et al. Voriconazole brain tissue levels in rhinocerebral aspergillosis in a successfully treated young woman. Int J Antimicrob Agents 2006;28:262-5.
32. Courtney R, Pai S, Laughlin M, Lim J, Batra V. Pharmacokinetics, safety and tolerability of oral posaconazole administered in single and multiple doses in healthy adults. Antimicrob Agents Chemother 2003;47:2788-95.
33. Torres HA, Hachem RY, Chemaly RF, Kontoyiannis DP, Raad II. Posaconazole: A broad-spectrum triazole antifungal. Lancet Infect Dis 2005;5:775-85.
34. Perfect JR, Cox GM, Dodge RK, Schell WA. In vitro and in vivo efficacies of the azole SCH56592 against Cryptococcus neoformans. Antimicrob Agents Chemother 1996;40:1910-3.
35. Mellinghoff IK, Winston DJ, Mukwaya G, Schiller GJ. Treatment of Scedosporium apiospermum brain abscesses with posaconazole. Clin Infect Dis 2002;34:1648-50.
36. Pitisuttithum P, Negroni R, Graybill JR, Bustamante B, Pappas P, Chapman S, et al. Activity of posaconazole in the treatment of central nervous system fungal infections. J Antimicrob Chemother 2005;56:745-55.
37. Groll AH, Mickiene D, Petraitis V, Petraitiene R, Kelaher A, Sarafandi A, et al. Compartmental pharmacokinetics and tissue distribution of the antifungal triazole ravuconazole following intravenous administration of its di-lysine phosphoester prodrug (BMS-379224) in rabbits. J Antimicrob Chemother 2005;56:899-907.
38. Brouwer AE, Teparrukkul P, Pinpraphaporn S, Larsen RA, Chierakul W, Peacock S, et al. Baseline correlation and comparative kinetics of cerebrospinal fluid colony-forming unit counts and antigen titers in cryptococcal meningitis. J Infect Dis 2005;192:681-4.
39. Saag MS, Graybill RJ, Larsen RA, Pappas PG, Perfect JR, Powderly WG, et al. Practice guidelines for the management of cryptococcal disease. Infectious Diseases Society of America. Clin Infect Dis 2000;30:710-8.
40. Benson CA, Kaplan JE, Masur H, Pau A, Holmes KK. Treating opportunistic infections among HIV-infected adults and adolescents. Centers for Disease Control and Prevention 2006;55:1-112.
41. Blanche P, Gombert B, Ginsburg C, Passeron A, Stubei I, Rigolet A, et al. HIV combination therapy: Immune restitution causing cryptococcal lymphadenitis dramatically improved by anti-inflammatory therapy. Scand J Infect Dis 1998;30:615-6.
42. Jenny-Avital ER, Abadi M. Immune reconstitution cryptococcosis after initiation of successful highly active antiretroviral therapy. Clin Infect Dis 2002;35:e128-33.
43. Lanzafame M, Trevenzoli M, Carretta G, Lazzarini L, Vento S, Concia E. Mediastinal lymphadenitis due to cryptococcal infection in HIV-positive patients on highly active antiretroviral therapy. Chest 1999;116:848-9.
44. Manfredi R, Pieri F, Pileri SA, Chiodo F. The changing face of AIDS-related opportunism: Cryptococcosis in the highly active antiretroviral therapy (HAART) era. Case reports and literature review. Mycopathologia 1999;148:73-8.
45. Trevenzoli M, Cattelan AM, Rea F, Sasset L, Semisa M, Lanzafame M, et al. Mediastinitis due to cryptococcal infection: A new clinical entity in the HAART era. J Infect 2002;45:173-9.
46. Bekker LG, Jaspan H, McIntyre J, Wood R, Gray G. Adolescents and HIV vaccine trials: What are the clinical trial site issues? J Int Assoc Physicians AIDS Care (Chic Ill) 2005;4:93-7.
47. nd, Allworth A. Immune reconstitution inflammatory syndrome producing atypical presentations of cryptococcal meningitis: Case report and a review of immune reconstitution-associated cryptococcal infections. Scand J Infect Dis 2006;38:219-21.
48. Cinti SK, Armstrong WS, Kauffman CA. Case report. Recurrence of increased intracranial pressure with antiretroviral therapy in an AIDS patient with cryptococcal meningitis. Mycoses 2001;44:497-501.
49. nd, MacGinley R, Eisen DP, Allworth AM. HIV combination therapy: Partial immune restitution unmasking latent cryptococcal infection. AIDS 1998;12:1491-4.
50. Breton G, Seilhean D, Cherin P, Herson S, Benveniste O. Paradoxical intracranial cryptococcoma in a human immunodeficiency virus-infected man being treated with combination antiretroviral therapy. Am J Med 2002;113:155-7.
51. Benjamin DK Jr, Stoll BJ, Fanaroff AA, McDonald SA, Oh W, Higgins RD, et al. Neonatal candidiasis among extremely low birth weight infants: Risk factors, mortality rates and neurodevelopmental outcomes at 18 to 22 months. Pediatrics 2006;117:84-92.
52. Chesney PJ, Justman RA, Bogdanowicz WM. Candida meningitis in newborn infants: A review and report of combined amphotericin B - flucytosine therapy. Johns Hopkins Med J 1978;142:155-60.
53. Faix RG. Systemic Candida infections in infants in intensive care nurseries: High incidence of central nervous system involvement. J Pediatr 1984;105:616-22.
54. Fernandez M, Moylett EH, Noyola DE, Baker CJ. Candidal meningitis in neonates: A 10-year review. Clin Infect Dis 2000;31:458-63.
55. Chen TL, Tsai CA, Fung CP, Lin MY, Yu KW, Liu CY. Clinical significance of Candida species isolated from cerebrospinal fluid. J Microbiol Immunol Infect 2002;35:249-54.
56. Geers TA, Gordon SM. Clinical significance of Candida species isolated from cerebrospinal fluid following neurosurgery. Clin Infect Dis 1999;28:1139-47.
57. Montero A, Romero J, Vargas JA, Regueiro CA, Sánchez-Aloz G, De Prados F, et al. Candida infection of cerebrospinal fluid shunt devices: Report of two cases and review of the literature. Acta Neurochir (Wien) 2000;142:67-74.
58. Nguyen MH, Yu VL. Meningitis caused by Candida species: An emerging problem in neurosurgical patients. Clin Infect Dis 1995;21:323-7.
59. Casado JL, Quereda C, Oliva J, Navas E, Moreno A, Pintado V, et al. Candidal meningitis in HIV-infected patients: Analysis of 14 cases. Clin Infect Dis 1997;25:673-6.
60. Chaabane M, Krifa H, Ladeb MF, Bouhaouala MH, Ben Hammouda M, Ataalah R, et al. Cerebral candidiasis. Computed tomography appearance. Pediatr Radiol 1989;19:436.
61. Fleischmann J, Church JA, Lehrer RI. Primary Candida meningitis and chronic granulomatous disease. Am J Med Sci 1986;291:334-41.
62. Levy R, Segal E, Barr-Nea L. Systemic candidiasis in mice immunized with Candida albicans ribosomes. Mycopathologia 1985;91:17-22.
63. Liu KH, Wu CJ, Chou CH, Lee HC, Lee NY, Hung ST, et al. Refractory candidal meningitis in an immunocompromized patient cured by caspofungin. J Clin Microbiol 2004;42:5950-3.
64. Ludviksson BR, Thorarensen O, Gudnason T, Halldorsson S. Candida albicans meningitis in a child with myeloperoxidase deficiency. Pediatr Infect Dis J 1993;12:162-4.
65. Ralph ED, Hussain Z. Chronic meningitis caused by Candida albicans in a liver transplant recipient: Usefulness of the polymerase chain reaction for diagnosis and for monitoring treatment. Clin Infect Dis 1996;23:191-2.
66. Rodriguez-Arrondo F, Aguirrebengoa K, De Arce A, Arrizabalaga J, Iribarren JA, Von Wichmann MA, et al. Candidal meningitis in HIV-infected patients: Treatment with fluconazole. Scand J Infect Dis 1998;30:417-8.
67. Smego RA Jr, Devoe PW, Sampson HA, Perfect JR, Wilfert CM, Buckley RH. Candida meningitis in two children with severe combined immunodeficiency. J Pediatr 1984;104:902-4.
68. Moylett EH. Neonatal Candida meningitis. Semin Pediatr Infect Dis 2003;14:115-22.
69. Pappas PG, Rex JH, Sobel JD, Filler SG, Dismukes WE, Walsh TJ, et al. Guidelines for treatment of candidiasis. Clin Infect Dis 2004;38:161-89.
70. Francis P, Walsh TJ. Evolving role of flucytosine in immunocompromised patients: New insights into safety, pharmacokinetics and antifungal therapy. Clin Infect Dis 1992;15:1003-18.
71. Pickering LJ, Baker CJ, Long SS, McMillan JA. Red Book: 2006 Report on the Committee on Infectious Diseases; 2006.
72. Block ER, Bennett JE. Pharmacological studies with 5-fluorocytosine. Antimicrob Agents Chemother 1972;1:476-82.
73. Haubrich RH, Haghighat D, Bozzette SA, Tilles J, McCutchan JA. High-dose fluconazole for treatment of cryptococcal disease in patients with human immunodeficiency virus infection. The California Collaborative Treatment Group. J Infect Dis 1994;170:238-42.
74. Thaler F, Bernard B, Tod M, Jedynak CP, Petitjean O, Derome P, et al. Fluconazole penetration in cerebral parenchyma in humans at steady state. Antimicrob Agents Chemother 1995;39:1154-6.
75. Medoff G, Comfort M, Kobayashi GS. Synergistic action of amphotericin B and 5-fluorocytosine against yeast-like organisms. Proc Soc Exp Biol Med 1971;138:571-4.
76. Jafari HS, Saez-Llorens X, Severien C, Parras F, Friedland I, Rinderknecht S, et al. Effects of antifungal therapy on inflammation, sterilization and histology in experimental Candida albicans meningitis. Antimicrob Agents Chemother 1994;38:83-9.
77. Epelbaum S, Laurent C, Morin G, Berquin P, Piussan C. Failure of fluconazole treatment in Candida meningitis. J Pediatr 1993;123:168-9.
78. Huttova M, Hartmanova I, Kralinsky K, Filka J, Uher J, Kurak J, et al. Candida fungemia in neonates treated with fluconazole: Report of forty cases, including eight with meningitis. Pediatr Infect Dis J 1998;17:1012-5.
79. Gaviria JM, Grohskopf LA, Barnes R, Root RK. Successful treatment of rhinocerebral zygomycosis: A combined-strategy approach. Clin Infect Dis 1999;28:160-1.
80. Imai J, Singh G, Fernandez B, Clemons KV, Stevens DA. Efficacy of Abelcet and caspofungin, alone or in combination, against CNS aspergillosis in a murine model. J Antimicrob Chemother 2005;56:166-71.
81. Revankar SG, Sutton DA, Rinaldi MG. Primary central nervous system phaeohyphomycosis: A review of 101 cases. Clin Infect Dis 2004;38:206-16.
82. Chin T, Fong IW, Vandenbroucke A. Pharmacokinetics of fluconazole in serum and cerebrospinal fluid in a patient with AIDS and cryptococcal meningitis. Pharmacotherapy 1990;10:305-7.
83. Groll AH, Mickiene D, Petraitiene R, Petraitis V, Lyman CA, Bacher JS, et al. Pharmacokinetic and pharmacodynamic modeling of anidulafungin (LY303366): Reappraisal of its efficacy in neutropenic animal models of opportunistic mycoses using optimal plasma sampling. Antimicrob Agents Chemother 2001;45:2845-55.
84. Groll AH, Mickiene D, Petraitis V, Petraitiene R, Ibrahim KH, Piscitelli SC, et al. Compartmental pharmacokinetics and tissue distribution of the antifungal echinocandin lipopeptide micafungin (FK463) in rabbits. Antimicrob Agents Chemother 2001;45:3322-7.
85. Hajdu R, Thompson R, Sundelof JG, Pelak BA, Bouffard FA, Dropinski JF, et al. Preliminary animal pharmacokinetics of the parenteral antifungal agent MK-0991 (L-743,872). Antimicrob Agents Chemother 1997;41:2339-44.
86. Arevalo MP, Carrillo-Munoz AJ, Salgado J, Cardenes D, Brió S, Quindós G, et al. Antifungal activity of the echinocandin anidulafungin (VER002, LY-303366) against yeast pathogens: A comparative study with M27-A microdilution method. J Antimicrob Chemother 2003;51:163-6.
87. Cuenca-Estrella M, Gomez-Lopez A, Mellado E, Buitrago MJ, Monzon A, Rodriguez-Tudela JL. Head-to-head comparison of the activities of currently available antifungal agents against 3,378 Spanish clinical isolates of yeasts and filamentous fungi. Antimicrob Agents Chemother 2006;50:917-21.
88. Cuenca-Estrella M, Gomez-Lopez A, Mellado E, Garcia-Effron G, Monzon A, Rodriguez-Tudela JL. In vitro activity of ravuconazole against 923 clinical isolates of nondermatophyte filamentous fungi. Antimicrob Agents Chemother 2005;49:5136-8.
89. Diekema DJ, Messer SA, Hollis RJ, Jones RN, Pfaller MA. Activities of caspofungin, itraconazole, posaconazole, ravuconazole, voriconazole and amphotericin B against 448 recent clinical isolates of filamentous fungi. J Clin Microbiol 2003;41:3623-6.
90. Kohler LM, Soares BM, de Assis Santos D, Da Silva Barros ME, Hamdan JS. In vitro susceptibility of isolates of Sporothrix schenckii to amphotericin B, itraconazole and terbinafine: Comparison of yeast and mycelial forms. Can J Microbiol 2006;52:843-7.
91. Petranyi G, Meingassner JG, Mieth H. Antifungal activity of the allylamine derivative terbinafine in vitro. Antimicrob Agents Chemother 1987;31:1365-8.
92. Pfaller MA, Messer SA, Hollis RJ, Jones RN; SENTRY Participants Group. Antifungal activities of posaconazole, ravuconazole, and voriconazole compared to those of itraconazole and amphotericin B against 239 clinical isolates of Aspergillus spp. and other filamentous fungi: Report from SENTRY Antimicrobial Surveillance Program, 2000. Antimicrob Agents Chemother 2002;46:1032-7.
93. Pfaller MA, Messer SA, Hollis RJ, Jones RN, Diekema DJ. In vitro activities of ravuconazole and voriconazole compared with those of four approved systemic antifungal agents against 6,970 clinical isolates of Candida spp. Antimicrob Agents Chemother 2002;46:1723-7.
94. Sabatelli F, Patel R, Mann PA, Mendrick CA, Norris CC, Hare R, et al. In vitro activities of posaconazole, fluconazole, itraconazole, voriconazole and amphotericin B against a large collection of clinically important molds and yeasts. Antimicrob Agents Chemother 2006;50:2009-15.
95. Tawara S, Ikeda F, Maki K, Morishita Y, Otomo K, Teratani N, et al. In vitro activities of a new lipopeptide antifungal agent, FK463, against a variety of clinically important fungi. Antimicrob Agents Chemother 2000;44:57-62.