Cerebrospinal fluid: a target of some fungi and an overview

Abstract

Meningitis is a potentially life-threatening infection characterised by the inflammation of the leptomeningeal membranes. The estimated annual prevalence of 8.7 million cases globally and the disease is caused by many different viral, bacterial, and fungal pathogens. Although several genera of fungi are capable of causing infections in the central nervous system (CNS), the most significant number of registered cases have, as causal agents, yeasts of the genus Cryptococcus . The relevance of cryptococcal meningitis has changed in the last decades, mainly due to the increase in the number of people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and medications that impair the immune responses. In this context, coronavirus disease 19 (COVID-19) has also emerged as a risk factor for invasive fungal infections (IFI), including fungal meningitis (FM), due to severe COVID-19 disease is associated with increased pro-inflammatory cytokines, interleukin (IL)-1, IL-6, and tumour necrosis factor-alpha, reduced CD4-interferon-gamma expression, CD4 and CD8 T cells. The gold standard technique for fungal identification is isolating fungi in the culture of the biological material, including cerebrospinal fluid (CSF). However, this methodology has as its main disadvantage the slow or null growth of some fungal species in culture, which makes it difficult to finalise the diagnosis. In conclusions, this article, in the first place, point that it is necessary to accurately identify the etiological agent in order to assist in the choice of the therapeutic regimen for the patients, including the implementation of actions that promote the reduction of the incidence, lethality, and fungal morbidity, which includes what is healthy in the CNS.

Screening of Candida spp. in wastewater in Brazil during COVID-19 pandemic: workflow for monitoring fungal pathogens

“…Pathogenic and opportunistic fungi possess an arsenal of virulence attributes that allow them to survive and cause infection in the hostile environment of the human body. These factors interfere with antigen presentation and skew the T-cell response toward a nonprotective Th2 phenotype [60]. The ability to produce different classes of hydrolytic enzymes and to form biofilm are well-known virulence factors involved in Candida sp.…”

Meningeal Syndrome: Diagnostic Algorithm, Treatment Tactics

“…3) bacterial serous meningitis -caused by such bacteria as Mycobacterium tuberculosis [30], Borrellia [31], Leptospira, Listeria monocytogenes [32], Treponema pallidum (neurosyphilis), Francisella tularensis (tularemia), Brucella (neurobrucellosis); 4) fungal meningitis (serous or purulent) [33] is mainly caused by Candida, Cryptococcus neoformans [34,35,36], and Aspergillus.…”

“…3) бактеріальні серозні менінгіти -спричиняються такими бактеріями, як Mycobacterium tuberculosis [30], Borrеllia [31], Leptospira, Listeria monocytogenes [32], Treponema pallidum (нейросіфіліс), Francisella tularensis (туляремія), Brucella (нейробруцельоз); 4) грибковий менінгіт (серозний або гнійний) [33] у більшості зумовлений Candida, Cryptococcus neoformans [34,35,36], Aspergillus.…”