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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

Central Nervous System Fungal Infections in Pakistan: A Narrative Review and Descriptive Synthesis

Fiza Ismail1, Farah Ismail1, Joshua Jamil2

  • 1Medicine, Continental Medical College, Lahore, PAK.

Cureus
|July 28, 2026
PubMed

Insights

Central nervous system (CNS) fungal infections present with vague symptoms in Pakistan, often affecting immunocompromised individuals. Combined medical and surgical treatment improves outcomes, but high mortality underscores the need for earlier diagnosis and intervention.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Mycology

Background:

  • Central nervous system (CNS) fungal infections pose a significant global health challenge, particularly for immunocompromised populations.
  • These infections are associated with high rates of morbidity and mortality worldwide.

Purpose of the Study:

  • To characterize the spectrum of CNS fungal infections in Pakistan.
  • To identify common pathogens, clinical presentations, comorbidities, and treatment outcomes.

Main Methods:

  • A narrative review of 14 studies with histologically confirmed CNS fungal infections.
  • Data from 140 patients were analyzed, including demographics, symptoms, comorbidities, management, and outcomes.

Main Results:

  • Headache, visual disturbances, and limb weakness were the most common symptoms.
  • Aspergillus and Mucorales were the most frequent fungal pathogens identified.
  • Combined medical (amphotericin B, voriconazole) and surgical management improved outcomes compared to medical therapy alone, though mortality remained high (36.28% with combined therapy vs. 65.38% with medical therapy alone).
  • Diabetes mellitus was the most common comorbidity.

Conclusions:

  • CNS fungal infections in Pakistan often present with nonspecific symptoms, complicating early diagnosis.
  • Multimodal management, combining medical and surgical approaches, is crucial.
  • High mortality rates highlight the urgent need for improved diagnostic strategies and timely intervention.
Keywords:
aspergillosisbrain diseasescentral nervous systemcerebral abscessfungalmeningitisfungal infections

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