Skip to main content

Main menu

  • Home
  • Content
    • Current Issue
    • Ahead of Print
    • Past Issues
    • Supplements
    • Article Type
  • Specialty
    • Articles by Specialty
  • CME/MOC
    • Articles
    • Calendar
  • Info For
    • Manuscript Submission
    • Authors & Reviewers
    • Subscriptions
    • About CCJM
    • Contact Us
    • Media Kit
  • Conversations with Leaders
  • Conference Coverage
    • Kidney Week 2024
    • CHEST 2024
    • ACR Convergence 2023
    • Kidney Week 2023
    • ObesityWeek 2023
    • IDWeek 2023
    • CHEST 2023
    • MDS 2023
    • IAS 2023
    • ACP 2023
    • AAN 2023
    • ACC / WCC 2023
    • AAAAI Meeting 2023
    • ACR Convergence 2022
    • Kidney Week 2022
    • AIDS 2022
  • Other Publications
    • www.clevelandclinic.org

User menu

  • Register
  • Log in

Search

  • Advanced search
Cleveland Clinic Journal of Medicine
  • Other Publications
    • www.clevelandclinic.org
  • Register
  • Log in
Cleveland Clinic Journal of Medicine

Advanced Search

  • Home
  • Content
    • Current Issue
    • Ahead of Print
    • Past Issues
    • Supplements
    • Article Type
  • Specialty
    • Articles by Specialty
  • CME/MOC
    • Articles
    • Calendar
  • Info For
    • Manuscript Submission
    • Authors & Reviewers
    • Subscriptions
    • About CCJM
    • Contact Us
    • Media Kit
  • Conversations with Leaders
  • Conference Coverage
    • Kidney Week 2024
    • CHEST 2024
    • ACR Convergence 2023
    • Kidney Week 2023
    • ObesityWeek 2023
    • IDWeek 2023
    • CHEST 2023
    • MDS 2023
    • IAS 2023
    • ACP 2023
    • AAN 2023
    • ACC / WCC 2023
    • AAAAI Meeting 2023
    • ACR Convergence 2022
    • Kidney Week 2022
    • AIDS 2022
Departments

Fungal organisms in the brain (February 2017)

Sanjay Mukhopadhyay, MD, Andrea V. Arrossi, MD and Carol F. Farver, MD
Cleveland Clinic Journal of Medicine June 2017, 84 (6) 428; DOI: https://doi.org/10.3949/ccjm.84c.06001
Sanjay Mukhopadhyay
Department of Pathology, Cleveland Clinic
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Andrea V. Arrossi
Department of Pathology, Cleveland Clinic
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Carol F. Farver
Departments of Pathology, Education, Pathobiology, Pulmonary Medicine, and Transplantation Center, Cleveland Clinic
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • PDF
Loading

TO THE EDITOR: In their Clinical Picture article in the February 2017 issue, Barbaryan et al1 describe brain lesions in a young woman with human immunodeficiency virus infection who presented with seizures. Figure 3 illustrates Grocott-Gomori methenamine silver (GMS)-positive fungal organisms in a brain biopsy. The organisms appear helmet-shaped and crescent-shaped and contain an intracystic dot, morphologic features of Pneumocystis jiroveci cysts.2 We could not appreciate features of Histoplasma yeasts (smaller yeasts with diameter of 3 to 5 µm, oval to tapered shape, and narrow-based budding).

The distinction between the two organisms can occasionally be challenging because there is some degree of overlap in size and shape, and both are GMS-positive. It is interesting that in the current case, serologic studies for Histoplasma were positive. Multiple infections with opportunistic organisms are not uncommon in severely immunocompromised individuals, and it is possible that the patient may also have had concurrent histoplasmosis. Brain lesions caused by Pneumocystis, although rare, have been previously reported.3–5 Immunohistochemistry for Pneumocystis may be of interest in this very unusual case.

Footnotes

  • [Editor’s note: Letters that comment on articles published in the Journal are sent to the author(s) for response. In this case, the authors felt that the letter did not require a reply.]

  • Copyright © 2017 The Cleveland Clinic Foundation. All Rights Reserved.

REFERENCES

  1. ↵
    1. Barbaryan A,
    2. Modi J,
    3. Raqeem W,
    4. Choi MI,
    5. Frigy A,
    6. Mirrakhimov AE
    . Ring-enhancing cerebral lesions. Cleve Clin J Med 2017; 84:104–105, 110.
    OpenUrlFREE Full Text
  2. ↵
    1. Mukhopadhyay S,
    2. Gal AA
    . Granulomatous lung disease. An approach to the differential diagnosis. Arch Pathol Lab Med 2010; 134:667–690.
    OpenUrlPubMed
  3. ↵
    1. Mayayo E,
    2. Vidal F,
    3. Almira R,
    4. Gonzalez J,
    5. Richart C
    . Cerebral Pneumocystis carinii infection in AIDS. Lancet 1990; 336:1592.
    OpenUrlPubMed
    1. Bartlett JA,
    2. Hulette C
    . Central nervous system pneumocystosis in a patient with AIDS. Clin Infect Dis 1997;25:82–85.
    OpenUrlCrossRefPubMed
  4. ↵
    1. Vidal F,
    2. Mirón M,
    3. Sirvent JJ,
    4. Richart C
    . Central nervous system pneumocystosis in AIDS: antemortem diagnosis and successful treatment. Clin Infect Dis 2000; 30:397–398.
    OpenUrlCrossRefPubMed
PreviousNext
Back to top

In this issue

Cleveland Clinic Journal of Medicine: 84 (6)
Cleveland Clinic Journal of Medicine
Vol. 84, Issue 6
1 Jun 2017
  • Table of Contents
  • Table of Contents (PDF)
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Cleveland Clinic Journal of Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Fungal organisms in the brain (February 2017)
(Your Name) has sent you a message from Cleveland Clinic Journal of Medicine
(Your Name) thought you would like to see the Cleveland Clinic Journal of Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Fungal organisms in the brain (February 2017)
Sanjay Mukhopadhyay, Andrea V. Arrossi, Carol F. Farver
Cleveland Clinic Journal of Medicine Jun 2017, 84 (6) 428; DOI: 10.3949/ccjm.84c.06001

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Fungal organisms in the brain (February 2017)
Sanjay Mukhopadhyay, Andrea V. Arrossi, Carol F. Farver
Cleveland Clinic Journal of Medicine Jun 2017, 84 (6) 428; DOI: 10.3949/ccjm.84c.06001
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Linkedin Share Button

Jump to section

  • Article
    • Footnotes
    • REFERENCES
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

Departments

  • Our Peer-Reviewers for 2023
  • When should we consider SGLT-2 inhibitors in patients with acute decompensated heart failure?
  • Our Peer-Reviewers For 2022
Show more Departments

Letters to the editor

  • In Reply: In defense of the anion gap
  • In defense of the anion gap
  • In Reply: Insomnia in older adults
Show more Letters to the editor

Similar Articles

Subjects

  • Imaging
  • Infectious Diseases
  • Neurology

Navigate

  • Current Issue
  • Past Issues
  • Supplements
  • Article Type
  • Specialty
  • CME/MOC Articles
  • CME/MOC Calendar
  • Media Kit

Authors & Reviewers

  • Manuscript Submission
  • Authors & Reviewers
  • Subscriptions
  • About CCJM
  • Contact Us
  • Cleveland Clinic Center for Continuing Education
  • Consult QD

Share your suggestions!

Copyright © 2025 The Cleveland Clinic Foundation. All rights reserved. The information provided is for educational purposes only. Use of this website is subject to the website terms of use and privacy policy. 

Powered by HighWire