Opportunistic Infections of the Central Nervous System

Christina C. Chang Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne VIC Introduction People with HIV (PWH) presenting with central nervous system (CNS) manifestations require careful assessment as the differentials are broad. Key factors in the history and examination to narrow down the diagnostic possibilities include a sudden vs. insidious onset; an acute …

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Cryptococcal disease (cryptococcosis) is caused by Cryptococcus neoformans – Cryptococcus gattii complex, a ubiquitous environmental yeast that is endemic in many countries including Australia. While cryptococcosis can affect many organs, cryptococcal meningoencephalitis is the most frequently recognised, and most severe form with mortality rates, ranging from 24%-47% at 10 weeks.(5-8). Clinical presentation Patients typically present …

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Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the CNS caused by reactivation of John Cunningham virus (JCV). This rare condition is associated with advanced immunosuppression almost exclusively – malignancy, HIV, organ transplantation, and immunomodulatory agents. Clinical features The demyelination involves white matter and can involve grey matter. In classical PML, the signs and …

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Chang CC, Harrison TS, Bicanic TA, Chayakulkeeree M, Sorrell TC, Warris A, et al. Global guideline for the diagnosis and management of cryptococcosis: an initiative of the ECMM and ISHAM in cooperation with the ASM. Lancet Infect Dis. 2024;24(8):e495-e512. HIV. PoGftPaToOIiAaAw. Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with …

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