The standard treatment of hydrocephalus consists of the implantation of a cerebrospinal fluid (CSF) shunt. Infection of the CSF shunts affects 5%-15% of the patients, primarily due to bacterial pathogens, with rare cases involving fungi. This study aimed to systematically review the clinical characteristics, diagnostic approaches, treatment strategies, and outcomes of fungal CSF shunt infections in children. A systematic review was conducted according to the PRISMA guidelines. PubMed, Scopus, Web of Science, Mendeley, and Cochrane Library databases were searched for studies on fungal CSF shunt infection in children, published from inception until 6 September 2024. A total of 26 studies reporting on 38 pediatric patients were found eligible, including our institutional case; a total of 39 patients were analyzed. Candida genus remained the most common causative agent (76.92%), with Candida albicans being the most prevalent (58.97%). CSF culture confirmed the infection in 77.78% of the cases. Amphotericin B was the most frequently used antifungal agent in monotherapy (55.56%). The primary route of administration was intravenous (92.86%), while intraventricular and intrathecal administration were used in 27.59%, and 20.00% of patients, respectively. Notably, 5.13% patients underwent fungal vegetation removal. Both the recurrence and the mortality rates were 10.81%. Fungal CSF shunt infections pose significant therapeutic challenges, necessitating the implementation of a broad treatment strategy to achieve successful outcomes. Intraventricular and intrathecal antifungal drug administration may become necessary, especially in persistent fungal infections.

Background: Multiple sclerosis (MS) and autoimmune diseases (AIDs) share immunological underpinnings, leading to frequent co-occurrence. This study investigated the prevalence of AIDs among Polish patients with MS (PwMSs) and its potential effects on disease characteristics. The aims were to compare clinical and demographic characteristics between PwMSs with and without coexisting AIDs. Methods: A retrospective analysis was conducted on data from 580 PwMSs who were treated at the Department of Neurology, University Clinical Center in Katowice, Poland, between February 2018 and August 2023. Variables analyzed included age, sex, MS type, disease duration, treatment, Expanded Disability Status Scale (EDSS) scores, thyroid-stimulating hormone (TSH), and vitamin D3 serum concentrations. Results: AID was identified in 16.9% of PwMSs (n = 98). Compared with PwMSs without AIDs, PwMSs with AIDs exhibited significantly higher mean age (44.61 ± 11.40 vs. 42.24 ± 12.27 years; p = 0.0151), longer disease duration (10.77 ± 6.72 vs. 9.56 ± 7.19 years; p = 0.0102), and higher EDSS scores (2.97 ± 1.43 vs. 2.89 ± 1.84; p = 0.0261). Among PwMSs, the prevalence of AIDs was significantly higher in females (20.24%) compared to males (8.13%; p = 0.0022), and strongly associated with the relapsing-remitting MS subtype (p = 0.0352). Autoimmune thyroid diseases were markedly the most prevalent in PwMSs (hypothyroidism 7.24%). Conclusions: PwMSs with AIDs exhibit distinct characteristics, including older age, increased disease duration, and greater disability. Thyroid disorders are notably the most prevalent AIDs among PwMSs. These findings underscore the intricate interplay between AIDs and MS and highlight the necessity for further research into their long-term impact.

This study aims to present and analyze the institutional experience in the diagnosis, treatment, and postoperative outcomes of infantile brain tumors. A retrospective review was conducted of medical records of infants (aged ≤ 1 year) who underwent initial surgical treatment of supratentorial brain tumors between 2002 and 2024. Indications for tumor resection included mass effect, symptomatic lesions (e.g., increased intracranial pressure [ICP] or focal deficits), or radiologically confirmed tumor progression. Continuous data were summarized as medians or means and categorical variables as counts and percentages. Survival analyses were performed using the Kaplan-Meier method with log-rank testing, while Cox regression, logistic models, and Fisher's exact test assessed prognostic and functional associations (P < 0.05, Jamovi v2.6). Our analysis included 34 infants. Signs of ICP were observed in 65% of patients. Tumors were predominantly intraventricular (38%), with choroid plexus tumors being the most common (38%). The median follow-up was 48 months. Gross total resection was achieved in 58% of initial resections, while high-grade histopathology was independently correlated with incomplete tumor removal (P = 0.016). Additionally, high-grade tumors were also associated with poorer prognosis, with a 5-year overall survival of 63% compared to 100% for low-grade tumors. In our institutional experience, infants with supratentorial tumors often presented with late, nonspecific symptoms related to increased ICP. Surgical treatment focused on maximal safe resection, although complete removal was not always feasible in a single procedure.