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Fungal Infections Pathology: Implications for Immunosuppressive Activities

Fungal infections of the Central Nervous System (CNS) present with protean clinical manifestations such as meningitis, encephalitis or mass lesions and are being increasingly recognized due to an increase in the at-risk population, increased awareness and better diagnostic modalities. However, due to lack of specific clinical and imaging features, diagnosis and treatment are often delayed, resulting in severe morbidity and mortality. The spectrum of aetiological fungi, the predisposing risk factors and clinical syndromes encountered in developing countries are different from those reported in the West. There are a few reports of large series from India. 1–10 In this paper, we present 130 cases of histologically verified fungal infections of the CNS seen at a University Hospital in Southern India over a period of 17 years and highlight the features seen in tropical countries such as India between mid-1981 and mid-1991, 64 cases of deep mycotic infections were found in 890 consecutives necropsies (incidence 7 2%). Among these there were 26 gastrointestinal infections, with 12 cases affecting the upper gastrointestinal tract (mouth, oesophagus, and stomach) alone, seven the lower intestinal tract (duodenum, jejunum, ileum and colon) alone, and seven both sites. These last 14 cases are the subject of this report.


Jeannette Garcia-Diaz

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