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Update on fungal infections of the central nervous system

emerging pathogens and emerging diagnostics

Bloch, Karen C.a,b; Bailin, Samuel S.a

Current Opinion in Infectious Diseases: June 2019 - Volume 32 - Issue 3 - p 277–284
doi: 10.1097/QCO.0000000000000541
CNS INFECTIONS: Edited by Adarsh Bhimraj
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Purpose of review Fungal infections of the central nervous system (CNS) are relatively uncommon but associated with significant morbidity and mortality. We reviewed recent literature highlighting new approaches to management of these complex patients.

Recent findings Fungal infections are increasingly recognized as important causes of CNS disease in both immunocompromised and immunocompetent hosts. Globally, cryptococcal meningitis remains a leading cause of death in HIV-infected persons in resource-limited settings. Emerging fungal pathogens with increased virulence and resistance to numerous classes of antifungal agents have been identified and represent a management challenge. Newer diagnostic techniques focused on antigen detection or molecular amplification of fungal pathogens offer promise in the expediated diagnosis and treatment of CNS fungal infections.

Summary Meningitis and brain abscess because of invasive fungal pathogens are frequently fatal infections. Newer laboratory tests allowing antigen detection or molecular amplification from cerebrospinal fluid are more sensitive than culture and allow earlier initiation of effective therapy.

aDepartment of Medicine

bDepartment of Health Policy, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, USA

Correspondence to Karen C. Bloch, MD, MPH, FIDSA, FACP, Associate Professor, Medicine (Infectious Diseases) and Health Policy, Vanderbilt University School of Medicine, A-2200 Medical Center North, Vanderbilt University Medical Center, Nashville, TN 37232, USA. Tel: +1 615 322 2035; fax: +1 615 343 6160; e-mail: Karen.bloch@vumc.org

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