Velasco Jon, Revankar Sanjay
Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
Division of Infectious Diseases, Department of Medicine, Wayne State University, 3990 John R. Street, 5 Hudson, Detroit, MI 48201, USA.
J Fungi (Basel). 2019 Jul 10;5(3):60. doi: 10.3390/jof5030060.
Central nervous system (CNS) infections caused by brown-black or dematiaceous fungi are distinctly rare and represent a small proportion of infections termed phaeohyphomycoses. However, these are becoming more commonly reported. Though many fungi have been implicated in disease, most cases are caused by only a few species, being the most common. Most of the fungi described are molds, and often cause infection in immunocompetent individuals, in contrast to infection with other more common molds such as , which is usually seen in highly immunocompromised patients. Diagnosis is challenging, as there are no specific tests for this group of fungi. In addition, these infections are often refractory to standard drug therapies, requiring an aggressive combined surgical and medical approach to improve outcomes, yet mortality remains high. There are no standardized treatments due to a lack of randomized clinical trials, though guidelines have been published based on available data and expert opinion.
由棕黑色或暗色真菌引起的中枢神经系统（CNS）感染极为罕见，在称为暗色丝孢霉病的感染中占比很小。然而，此类感染的报告越来越多。尽管许多真菌都与疾病有关，但大多数病例仅由少数几种真菌引起，其中最为常见。所描述的大多数真菌为霉菌，通常在免疫功能正常的个体中引起感染，这与其他更常见的霉菌感染不同，例如，后者通常见于免疫功能极度低下的患者。诊断具有挑战性，因为针对这类真菌没有特异性检测方法。此外，这些感染通常对标准药物治疗无效，需要积极采取手术和药物联合治疗方法来改善预后，但死亡率仍然很高。由于缺乏随机临床试验，目前尚无标准化治疗方案，不过已根据现有数据和专家意见发布了指南。
