Angioinvasion severity and admission GCS predict outcomes in invasive central nervous system fungal infections.

Yushu Jiang, Shuhua Dai, Rui Pang, Lingzhi Qin, Milan Zhang, Huiqin Liu, Xiaojuan Wang, Jiewen Zhang, Wei Li

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Article in Frontiers in cellular and infection microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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9 authors.

Yushu JiangDepartment of Neurology, Henan Joint International Research Laboratory of Accurate Diagnosis, Treatment, Research And Development, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.

Shuhua DaiDepartment of Neurology, Zhoukou Central Hospital, Zhoukou, Henan, China.

Rui PangDepartment of Neurology, Henan Joint International Research Laboratory of Accurate Diagnosis, Treatment, Research And Development, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.

Lingzhi QinDepartment of Neurology, Henan Joint International Research Laboratory of Accurate Diagnosis, Treatment, Research And Development, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.

Milan ZhangDepartment of Neurology, Henan Joint International Research Laboratory of Accurate Diagnosis, Treatment, Research And Development, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.

Huiqin LiuDepartment of Neurology, Henan Joint International Research Laboratory of Accurate Diagnosis, Treatment, Research And Development, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.

Xiaojuan WangDepartment of Neurology, Henan Joint International Research Laboratory of Accurate Diagnosis, Treatment, Research And Development, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.

Jiewen ZhangDepartment of Neurology, Henan Joint International Research Laboratory of Accurate Diagnosis, Treatment, Research And Development, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.

Wei LiDepartment of Neurology, Henan Joint International Research Laboratory of Accurate Diagnosis, Treatment, Research And Development, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Central nervous system (CNS) invasive fungal infections caused by Methods: We performed a retrospective cohort study of 57 adults with proven or probable invasive CNS fungal infection (28 ROCM, 13 RA, 16 CA) treated between January 2018 and April 2025. An exploratory imaging-based angioinvasion severity score (0-3) was constructed from three radiographic markers: internal carotid artery involvement, cerebral infarction, and intracranial hemorrhage. The primary outcome was all-cause mortality during follow-up; 90-day mortality was also assessed. The secondary outcome was 90-day unfavorable functional outcome, defined as modified Rankin Scale (mRS) 3-6. Multivariable analyses used Cox regression, Firth penalized logistic regression, and proportional odds ordinal logistic regression. Results: ROCM had the highest 90-day mortality (43% vs. 7.7% in RA and 6.3% in CA; Conclusions: Higher angioinvasion severity was associated with worse neurological functional outcome, whereas admission GCS independently predicted both mortality and unfavorable functional outcome. These findings may assist early risk stratification and treatment planning in invasive CNS fungal infection.

Indexed as

Central Nervous System Fungal InfectionsGlasgow Coma ScaleInvasive Fungal InfectionsAdultAgedFemaleHumansMaleMiddle AgedMucormycosisPrognosisRetrospective StudiesSeverity of Illness Indexangioinvasionaspergillosiscentral nervous system fungal infectionsGlasgow Coma Scalemodified Rankin Scalemucormycosis

Identifiers

PMID42661638

DOI10.3389/fcimb.2026.1915699

PMCPMC13518185

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