Original ArticlesMagnetic Resonance Imaging in Fungal Infections of the BrainPalacios, Enrique MD, FACR*; Rojas, Rafael MD†; Rodulfa, Jason MD*; González-Toledo, Eduardo MD‡Author Information From the *Department of Radiology, Section of Neuroradiology, Tulane University School of Medicine, New Orleans, LA; †Department of Radiology, Section of Neuroradiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and ‡Department of Radiology, Section of Neuroradiology, Louisiana State University Medical Center, Shreveport, LA. Reprints: Enrique Palacios, MD, FACR, 107 English Turn Dr, New Orleans, LA 70131 (e-mail: email@example.com). The authors declare no conflict of interest. Topics in Magnetic Resonance Imaging: June 2014 - Volume 23 - Issue 3 - p 199-212 doi: 10.1097/RMR.0000000000000025 Buy Metrics Abstract An invasive fungal infection is a rare disease that can occur in otherwise healthy individuals. Fungi themselves are universal, and they are overall harmless organisms that cause at most a self-limiting disease in the general population. Immunocompromised individuals, whether iatrogenically, genetically, or acquired, present a group who are especially susceptible to a life-threatening disease from a normally innocuous pathogen. Fungi are normally inhaled and are cleared by pulmonary defense mechanisms in immunocompetent hosts. Invasion begins when these mechanisms fail in depressed immunity. Through bypassing of the pulmonary immune system, fungi can spread hematogenously. Fungal infections of the central nervous system are the most common extrapulmonary manifestation after fungal inhalation. Other risk factors of fungemia include prolonged indwelling catheters, maxillofacial infections, uncontrolled diabetes mellitus, systemic antibiotics, implanted neurosurgical devices, and intravenous drug abuse. Thus, other than direct inoculation via surgical complications or open trauma, central nervous system fungal infections are almost never primary. © 2014 Lippincott Williams & Wilkins, Inc.