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Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid for the Detection of Central Nervous System Pathogens
10:08

Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid for the Detection of Central Nervous System Pathogens

Published on: April 17, 2026

[Paracoccidioidomycosis compromising the central nervous system: a systematic review of the literature]

Vinicius Sousa Pietra Pedroso1, Márcia de Carvalho Vilela, Enio Roberto Pietra Pedroso

  • 1Curso de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG.

Revista Da Sociedade Brasileira De Medicina Tropical
|March 9, 2010
PubMed

Insights

Neuroparacoccidioidomycosis, a fungal infection of the central nervous system, predominantly affects men and presents with neurological deficits. Early diagnosis and treatment are crucial to reduce high mortality and severe sequelae.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Neurology

Background:

  • Neuroparacoccidioidomycosis (NPM) is a severe manifestation of Paracoccidioides brasiliensis infection affecting the central nervous system.
  • Limited systematic reviews exist, necessitating a comprehensive analysis of documented cases.

Purpose of the Study:

  • To conduct the first systematic review of neuroparacoccidioidomycosis cases.
  • To characterize the clinical presentation, diagnosis, treatment, and outcomes of NPM.

Main Methods:

  • Systematic literature search of MEDLINE and LILACS databases.
  • Inclusion of 257 cases from 81 published studies.
  • Analysis of patient demographics, clinical symptoms, lesion characteristics, diagnostic methods, and outcomes.

Main Results:

  • NPM predominantly affects adult men (93%), particularly farm laborers, with a mean age of 43.
  • Common symptoms include motor deficits and intracranial hypertension; the chronic pseudotumoral form is prevalent.
  • Lesions are typically supratentorial (66.8%), often in frontal/parietal lobes.
  • Diagnosis relies on biopsy (57.2%) and neuroimaging (64.6%).
  • High association with pulmonary disease (59.1%) and significant mortality (44.1%) with frequent sequelae (50.1%).

Conclusions:

  • NPM is a serious condition with high morbidity and mortality.
  • Consider NPM in the differential diagnosis of central nervous system expansive and meningoencephalitic processes.
  • Early diagnosis and treatment are essential to prevent disabling sequelae.

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