Advances in the diagnosis and treatment of fungal infections of the CNS

Stefan Schwartz, Dimitrios P. Kontoyiannis, Thomas Harrison, Markus Ruhnke

Research output: Contribution to journalReview articlepeer-review

79 Scopus citations

Abstract

Fungal infections of the CNS are challenging to treat and their optimal management requires knowledge of their epidemiology, host characteristics, diagnostic criteria, and therapeutic options. Aspergillus and Cryptococcus species predominate among fungal infections of the CNS. Most of these fungi are ubiquitous, but some have restricted geographical distribution. Fungal infections of the CNS usually originate from primary sites outside the CNS (eg, fungal pneumonia) or occur after inoculation (eg, invasive procedures). Most patients with these infections have immunodeficiencies, but immunocompetent individuals can also be infected through heavy exposure. The infecting fungi can be grouped into moulds, yeasts, and dimorphic fungi. Substantial progress has been made with new diagnostic approaches and the introduction of novel antifungal drugs, but fungal infections of the CNS are frequently lethal because of diagnostic delays, impaired drug penetration, resistance to antifungal treatments, and inadequate restoration of immune function. To improve outcomes, future research should advance diagnostic methods (eg, molecular detection and fungus identification), develop antifungal compounds with enhanced CNS-directed efficacy, and further investigate crucial host defence mechanisms.

Original languageEnglish (US)
Pages (from-to)362-372
Number of pages11
JournalThe Lancet Neurology
Volume17
Issue number4
DOIs
StatePublished - Apr 2018

ASJC Scopus subject areas

  • Clinical Neurology

Fingerprint

Dive into the research topics of 'Advances in the diagnosis and treatment of fungal infections of the CNS'. Together they form a unique fingerprint.

Cite this