Cerebrospinal fluid: a target of some fungi and an overview.

IF 2.5 4区 医学 Q2 PARASITOLOGY Memorias do Instituto Oswaldo Cruz Pub Date : 2023-01-01 DOI:10.1590/0074-02760220251
Danielly Corrêa-Moreira, Rodolfo Castro, Gisela Lara da Costa, Reginaldo Gonçalves Lima-Neto, Manoel Marques Evangelista Oliveira
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引用次数: 2

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.

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脑脊液:一些真菌的靶点及综述。
脑膜炎是一种潜在的危及生命的感染,其特征是小脑膜的炎症。据估计,全球每年有870万例病例,该病由许多不同的病毒、细菌和真菌病原体引起。虽然有几种真菌属能够引起中枢神经系统(CNS)的感染,但最显著的登记病例是隐球菌属的酵母菌作为病原体。隐球菌性脑膜炎的相关性在过去几十年中发生了变化,主要是由于感染人体免疫机能丧失病毒/获得性免疫机能丧失综合症(艾滋病毒/艾滋病)的人数增加以及损害免疫反应的药物。在这种背景下,冠状病毒病19 (COVID-19)也已成为侵袭性真菌感染(IFI)的危险因素,包括真菌脑膜炎(FM),因为严重的COVID-19疾病与促炎细胞因子、白细胞介素(IL)-1、IL-6和肿瘤坏死因子- α增加、CD4-干扰素- γ表达减少、CD4和CD8 T细胞减少有关。真菌鉴定的金标准技术是在包括脑脊液(CSF)在内的生物材料的培养中分离真菌。然而,这种方法的主要缺点是一些真菌物种在培养中生长缓慢或零生长,这使得难以最终诊断。综上所述,本文首先指出,有必要准确识别病原体,以帮助患者选择治疗方案,包括实施促进降低发病率、致死率和真菌发病率的行动,其中包括中枢神经系统的健康。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.00
自引率
3.60%
发文量
91
审稿时长
3-8 weeks
期刊介绍: Memórias do Instituto Oswaldo Cruz is a journal specialized in microbes & their vectors causing human infections. This means that we accept manuscripts covering multidisciplinary approaches and findings in the basic aspects of infectious diseases, e.g. basic in research in prokariotes, eukaryotes, and/or virus. Articles must clearly show what is the main question to be answered, the hypothesis raised, and the contribution given by the study. Priority is given to manuscripts reporting novel mechanisms and general findings concerning the biology of human infectious prokariotes, eukariotes or virus. Papers reporting innovative methods for diagnostics or that advance the basic research with these infectious agents are also welcome. It is important to mention what we do not publish: veterinary infectious agents research, taxonomic analysis and re-description of species, epidemiological studies or surveys or case reports and data re-analysis. Manuscripts that fall in these cases or that are considered of low priority by the journal editorial board, will be returned to the author(s) for submission to another journal.
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