The clinical characteristics of mold infections of the CNS warrant assessment for possible biopsy and neurosurgical intervention. A definitive diagnosis almost invariably requires a biopsy, with prompt inspection of the specimen by means of wet-mount preparation with calcofluor white stain, culture, and histologic analysis (with Gomori methenamine silver stain and periodic acid–Schiff stain). In situ hybridization and immunohistochemical analysis may be helpful if cultures of biopsy specimens are negative.
- Classic syndrome with cancer diagnosed within 5 years of neurological symptom development
- Nonclassic syndrome that resolves or significantly improves after cancer treatment
- Nonclassic syndrome with cancer diagnosed within 5 years of neurological symptom development and positive antineuronal antibodies
- Neurological syndrome (classic or not) without cancer and with well-characterized antineuronal antibodies