Understanding Research Gaps for Fungal Meningitis in the United States; Scoping Review

Abstract

Abstract Background This paper conducts a literature review and analysis on fungal meningitis (FM) which is a fungal infection that causes inflammation to the spinal cord and brain membranes. We identified a discrepancy in that most meningitis cases are due to bacterial causes and consequently more attention including control programmes is focused here. For example, meningitis vaccines are mainly focused on the bacterial cause while viral and FM seem to be neglected meanwhile there are still cases of FM. In this study, we sought to understand the existing evidence and areas for future research regarding the clinical epidemiology of FM in the US. Methods A protocol for human review was developed to inform this scoping review. A search of published studies on Google Scholar, Web of Science and PubMed was carried out using key search terms on 20th − 22nd May 2022 and 13th − 14th June 2023. We followed with manual searching of the grey literature to identify additional articles not captured through these sources. All articles that were accessed on these databases were appraised against a defined inclusion criterion. All ages, occupations and sexes of humans living in the USA. Furthermore, we also included all forms of FM detections through different diagnostic methods from registered and licensed suppliers for the diagnostics tools. Results Fungal meningitis is a fungal disease that causes the spinal and brain cord membrane inflammation. In the United States, Histoplasma meningitis is more common in the Midwest, such as the Ohio and Mississippi River valleys. In general, however, fungal meningitis was found to be most commonly prevalent in southern states, as fungi grow most in these areas. With this disease, the diagnostic process of fungal meningitis and the specific causative agent remains important and key to recovery. Some gaps of knowledge that were found were the lack of reliable diagnostic methods of FM, insufficient knowledge of the specific mechanisms of fungal pathogens when infecting the host and entering the brain, and uncertainty in the timing and length of antiretroviral therapy. Some future areas of research that we suggest are conducting more research on BDG testing in diagnosis, and generally focusing on advancing diagnostic methods of FM. We also suggest further studies in the understanding of pathogen interactions with the host, so that a greater understanding of the specific mechanisms during infection of FM can be reached. Trial registration Not applicable