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Fungal infections
L Chimelli1, M B Mahler-Araujo
1Departamento de Patologia, Faculdade de Medicina de Ribeirao Preto, SP, Brasil.
Abstract:
Fungal infections have increased in frequency in the last decades because of the growing number of immunocompromised patients who survive longer periods of time than in the past, the widespread use of immunosuppressive drugs, a large aging population with increased numbers of malignancies, and the spread of AIDS. Although fungi are present everywhere, some mycoses predominate in the tropics, not only in view of warm temperature and humid climate, which favor their growth, but also because of inadequate hygienic and working conditions brought about by poverty. Mycotic diseases in the brain are usually secondary to infections elsewhere in the body, usually the lungs, less often from other extracranial sites, and in the vast majority of the cases spread via blood circulation. Only occasionally they result from direct extensions from infections of the sinuses or bone, and less frequently from prosthetic heart valves. Candida may be endogenous in origin, inhabiting the digestive tract. Most fungi cause basal meningitis or intraparenchymal abscesses. Direct extension from the cribriform plate cause necro-hemorrhagic lesions in the base of the frontal lobe. Although fungi are common in our environment, few are pathogenic. In this paper mycotic infections are divided into opportunistic and pathogenic; although most of the latter have also been described in immunosuppressed patients, some of those caused by opportunistic organisms, have also occurred in the absence of predisposing factors.
Insights
Fungal infections are rising due to increased immunocompromised individuals and environmental factors. This review categorizes fungal infections as opportunistic or pathogenic, noting their varied origins and clinical presentations.
Area of Science:
- Mycology
- Infectious Diseases
- Neurology
Background:
- Increased incidence of fungal infections linked to rising immunocompromised populations, immunosuppressive drug use, aging demographics, malignancies, and AIDS.
- Tropical regions exhibit higher mycoses prevalence due to climate, humidity, and socioeconomic factors impacting hygiene and working conditions.
- Fungal brain infections are typically secondary, spreading hematogenously from pulmonary or other extracranial sites, with rare direct extension or prosthetic valve involvement.
Purpose of the Study:
- To review the increasing frequency and diverse causes of fungal infections.
- To categorize fungal infections into opportunistic and pathogenic types.
- To discuss the pathogenesis and common clinical manifestations of fungal mycoses, particularly in the brain.
Main Methods:
- Literature review and synthesis of existing data on fungal infections.
- Classification of mycoses based on etiological agents and host factors.
- Analysis of common routes of infection and resulting pathologies.
Main Results:
- Fungal infections are increasingly prevalent globally.
- Mycotic infections are categorized as opportunistic or pathogenic, with overlap in susceptible hosts.
- Common presentations include basal meningitis and intraparenchymal abscesses; direct extension can cause specific brain lesions.
Conclusions:
- Fungal infections pose a growing public health challenge, necessitating a thorough understanding of their epidemiology and pathogenesis.
- Distinguishing between opportunistic and pathogenic fungal infections is crucial for effective management.
- Fungal mycoses, especially neuroinfections, require prompt diagnosis and treatment, considering their varied origins and potential severity.