{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:27:43Z","timestamp":1790746063780,"version":"4.1.0"},"reference-count":67,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T00:00:00Z","timestamp":1613520000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T00:00:00Z","timestamp":1613520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Autopsy continues to play an essential role in monitoring opportunistic fungal infections. However, few studies have analysed the historical trends of fungal infections in autopsies. Here, we analyse available data on fungal infections obtained from autopsy reports during 85\u00a0years of autopsies performed by the largest autopsy service in Brazil. All invasive fungal infections presented in autopsy reports between 1930 and 2015 were included. Of the 158,404 autopsy reports analysed, 1096 involved invasive fungal infections. In general, paracoccidioidomycosis (24%) was the most frequent infection, followed by candidiasis (18%), pneumocystosis (11.7%), cryptococcosis (11%), aspergillosis (11%) and histoplasmosis (3.8%). Paracoccidioidomycosis decreased after the 1950s, whereas opportunistic fungal infections increased steadily after the 1980s during the peak of the AIDS pandemic. The lung was the most frequently affected organ (73%). Disseminated infection was present in 64.5% of cases. In 26% of the 513 cases for which clinical charts were available for review, the diagnosis of opportunistic fungal infections was performed only at autopsy. Our unique 85-year history of autopsies showed a transition from endemic to opportunistic fungal infections in S\u00e3o Paulo, Brazil, reflecting increased urbanization, the appearance of novel diseases, such as AIDS in the 1980s, and advances in medical care over time.<\/jats:p>","DOI":"10.1038\/s41598-021-83587-1","type":"journal-article","created":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T16:46:37Z","timestamp":1613753197000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["A single-centre, retrospective study of the incidence of invasive fungal infections during 85\u00a0years of autopsy service in Brazil"],"prefix":"10.1038","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1346-9003","authenticated-orcid":false,"given":"K\u00e1tia Cristina","family":"Dantas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thais","family":"Mauad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen D. Saldiva","family":"de Andr\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Luiza","family":"Bierrenbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Hil\u00e1rio Nascimento","family":"Saldiva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,17]]},"reference":[{"key":"83587_CR1","first-page":"358","volume":"45","author":"TJ Wash","year":"1980","unstructured":"Wash, T. J., Hutchins, G. M., Bulkley, B. H. & Mendelsohn, F. G. Fungal infections of the heart: Analysis of 51 autopsy Cases. Am. J. Cardiol. 45, 358\u2013366 (1980).","journal-title":"Am. J. Cardiol."},{"key":"83587_CR2","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1086\/651262","volume":"50","author":"PG Pappas","year":"2010","unstructured":"Pappas, P. G. et al. Invasive fungal infections among organ transplant recipients: Results of the Transplant-Associated Infection Surveillance Network (Transnet). Clin. Infect. Dis. 50, 1101\u20131111 (2010).","journal-title":"Clin. Infect. Dis."},{"key":"83587_CR3","doi-asserted-by":"publisher","first-page":"1855","DOI":"10.3201\/eid1710.110087","volume":"17","author":"BJ Park","year":"2011","unstructured":"Park, B. J. et al. Invasive non-Aspergillus mold infections in transplant recipients, United States, 2001\u20132006. Emerg. Infect. Dis. 17, 1855\u20131864 (2011).","journal-title":"Emerg. Infect. Dis."},{"key":"83587_CR4","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1093\/jpids\/pix046","volume":"6","author":"ZD Pana","year":"2017","unstructured":"Pana, Z. D., Roilides, E., Warris, A., Groll, A. H. & Zaoutis, T. Epidemiology of invasive fungal disease in children. J. Pediatr. Infect. Dis. Soc. 6, S3\u2013S11 (2017).","journal-title":"J. Pediatr. Infect. Dis. Soc."},{"key":"83587_CR5","doi-asserted-by":"crossref","unstructured":"Dignani, M. C. Epidemiology of invasive fungal diseases on the basis of autopsy reports. F1000Prime Rep. 6, 1\u20137 (2014).","DOI":"10.12703\/P6-81"},{"key":"83587_CR6","unstructured":"Brasil. Minist\u00e9rio da Sa\u00fade. Cadastro Nacional de Estabelecimento da Sa\u00fade-CNESNet. http:\/\/cnes2.datasus.gov.br."},{"key":"83587_CR7","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1111\/myc.12427","volume":"59","author":"J Giacomazzi","year":"2016","unstructured":"Giacomazzi, J. et al. The burden of serious human fungal infections in Brazil. Mycoses 59, 145\u2013150 (2016).","journal-title":"Mycoses"},{"key":"83587_CR8","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1016\/S1473-3099(17)30243-8","volume":"17","author":"R Razasingham","year":"2017","unstructured":"Razasingham, R. et al. Global burden of disease of HIV\u2014Associated cryptococcocal meningitis: Updated analysis. Lancet Infect. Dis. 17, 873\u2013881 (2017).","journal-title":"Lancet Infect. Dis."},{"key":"83587_CR9","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1590\/S0074-02762009000300019","volume":"104","author":"M Prado","year":"2009","unstructured":"Prado, M., Silva, M. B., Laurenti, R., Travassos, L. R. & Taborda, C. P. Mortality due to systemic mycoses as a primary cause of death or in association with AIDS in Brazil: A review from 1996 to 2006. Mem. Inst. Oswaldo Cruz. 104, 513\u2013521 (2009).","journal-title":"Mem. Inst. Oswaldo Cruz."},{"issue":"19","key":"83587_CR10","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1590\/S0036-46652015000700004","volume":"57","author":"R Martinez","year":"2015","unstructured":"Martinez, R. Epidemiology of paracoccidioidomycosis. Rev. Inst. Med. Trop. Sao Paulo. 57(19), 11\u201320 (2015).","journal-title":"Rev. Inst. Med. Trop. Sao Paulo."},{"issue":"5","key":"83587_CR11","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.1590\/S0102-311X2002000500037","volume":"18","author":"ZF Coutinho","year":"2002","unstructured":"Coutinho, Z. F. et al. Paracoccidioidomycosis mortality in Brazil (1980\u20131995). Cad. Saude Publ. 18(5), 1441\u20131454 (2002).","journal-title":"Cad. Saude Publ."},{"issue":"6","key":"83587_CR12","doi-asserted-by":"publisher","first-page":"1856","DOI":"10.1590\/S0102-311X2005000600035","volume":"21","author":"JI Bittencourt","year":"2005","unstructured":"Bittencourt, J. I., de Oliveira, R. M. & Coutinho, Z. F. Paracoccidioidomycosis mortality in the State of Paran\u00e1, Brazil, 1980\/1998. Cad. Saude Publ. 21(6), 1856\u20131864 (2005).","journal-title":"Cad. Saude Publ."},{"key":"83587_CR13","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1590\/S1020-49892008000500003","volume":"23","author":"AH Santo","year":"2008","unstructured":"Santo, A. H. Tend\u00eancia da mortalidade relacionada \u00e0 paracoccidioidomicose, Estado de S\u00e3o Paulo, Brasil, 1985 a 2005: Estudo usando causas m\u00faltiplas de morte. Pan Am. J. Public Health. 23, 313\u2013324 (2008).","journal-title":"Pan Am. J. Public Health."},{"key":"83587_CR14","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1007\/s12281-018-0306-0","volume":"12","author":"S Antinori","year":"2018","unstructured":"Antinori, S., Corbellino, M. & Parravicini, C. Challenges in the diagnosis of invasive fungal infections in immunocompromised hosts. Curr. Fungal Infect. Rep. 12, 12\u201322 (2018).","journal-title":"Curr. Fungal Infect. Rep."},{"key":"83587_CR15","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1309\/AJCPRAAE8LZ7DTNE","volume":"132","author":"S Antinori","year":"2009","unstructured":"Antinori, S. et al. Trends in the postmortem diagnosis of opportunistic invasive fungal infections in patients with AIDS: A retrospective study of 1,630 autopsies performed between 1984 and 2002. Am. J. Clin. Pathol. 132, 221\u2013227 (2009).","journal-title":"Am. J. Clin. Pathol."},{"key":"83587_CR16","doi-asserted-by":"publisher","first-page":"344","DOI":"10.4103\/0377-4929.81634","volume":"54","author":"MS Uppin","year":"2011","unstructured":"Uppin, M. S. et al. Fungal infections as a contributing cause of death: An autopsy study. Indian J. Pathol. Microbiol. 54, 344\u2013349 (2011).","journal-title":"Indian J. Pathol. Microbiol."},{"key":"83587_CR17","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/j.prp.2012.06.004","volume":"208","author":"TE Colombo","year":"2012","unstructured":"Colombo, T. E., Soares, M., D\u2019Avilla, S. C., Nogueira, M. C. & De Almeida, M. T. Identification of fungal diseases at necropsy. Pathol. Res. Pract. 208, 549\u2013552 (2012).","journal-title":"Pathol. Res. Pract."},{"key":"83587_CR18","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1111\/myc.12081","volume":"56","author":"RE Lewis","year":"2013","unstructured":"Lewis, R. E. et al. Epidemiology and sites of involvement of invasive fungal infections in patients with haematological malignancies: A 20-year autopsy study. Mycoses 56, 638\u2013645 (2013).","journal-title":"Mycoses"},{"key":"83587_CR19","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1111\/j.1439-0507.2012.02169.x","volume":"55","author":"K Shimodaira","year":"2012","unstructured":"Shimodaira, K. et al. Trends in the prevalence of invasive fungal infections from an analysis of annual records of autopsy cases of Toho University. Mycoses 55, 435\u2013443 (2012).","journal-title":"Mycoses"},{"key":"83587_CR20","doi-asserted-by":"publisher","first-page":"522","DOI":"10.3109\/13693786.2012.755574","volume":"51","author":"Y Suzuki","year":"2013","unstructured":"Suzuki, Y., Kume, H., Togano, T., Kanoh, Y. & Ohto, H. Epidemiology of visceral mycoses in autopsy cases in Japan: The data from 1989 to 2009 in the Annual of Pathological Autopsy Cases in Japan. Med. Mycol. 51, 522\u2013526 (2013).","journal-title":"Med. Mycol."},{"key":"83587_CR21","doi-asserted-by":"publisher","unstructured":"Zhu, K. et al. An analysis of 60 years of autopsy data from Zhejiang University in Hangzhou, China. PLoS One. 9 (11), e112500, https:\/\/doi.org\/10.1371\/journal.pone.0112500 (2014).","DOI":"10.1371\/journal.pone.0112500"},{"key":"83587_CR22","doi-asserted-by":"crossref","unstructured":"Pompilio, C.E. & Vieira, J.E. The technological invention of Joaquim Edson Vieira disease and the decline of autopsies. Sao Paulo Med. J. 126(2), 71\u201372 (2008).","DOI":"10.1590\/S1516-31802008000200001"},{"key":"83587_CR23","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1016\/S0140-6736(18)31221-2","volume":"392","author":"F Marinho","year":"2018","unstructured":"Marinho, F. et al. Burden of disease in Brazil, 1990\u20132016: A systematic subnational analysis for the Global Burden of Disease Study 2016. Lancet 392, 760\u2013775 (2018).","journal-title":"Lancet"},{"key":"83587_CR24","unstructured":"Lacaz C. S. et al. Medical Mycological Treaty. 1\u2013410, 9th edn. (Savier, S\u00e3o Paulo, 2002)."},{"key":"83587_CR25","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1128\/CMR.00062-10","volume":"24","author":"J Shankar","year":"2011","unstructured":"Shankar, J., Restrepo, A., Clemons, K. V. & Stevens, D. A. Hormones and the resistance of women to paracoccidiodomycosis. Clin. Microbiol. Rev. 24, 296\u2013313 (2011).","journal-title":"Clin. Microbiol. Rev."},{"issue":"121\u2013124","key":"83587_CR26","first-page":"141","volume":"22","author":"A Lutz","year":"1908","unstructured":"Lutz, A. Uma mycose pseudococcidica localisada na bocca e observada no Brazil. Contribui\u00e7\u00e3o ao conhecimento das hiphoblastomycoses americanas.  Braz. M\u00e9d. 22(121\u2013124), 141\u2013144 (1908).","journal-title":"Braz. M\u00e9d."},{"key":"83587_CR27","first-page":"125","volume":"5","author":"FP Almeida","year":"1930","unstructured":"Almeida, F. P. Estudos comparativos de granuloma coccidi\u00f3idico nos Estados Unidos e no Brasil: Novo g\u00eanero para o parasito brasileiro. Na Fac. Med. S Paulo. 5, 125\u2013141 (1930).","journal-title":"Na Fac. Med. S Paulo."},{"key":"83587_CR28","unstructured":"Filho, A. S. Localiza\u00e7\u00f5es pulmonares da \u201cMicose de Lutz\u201d anatomia patol\u00f3gica e patogenia import\u00e2ncia de seu estudo na patologia pulmonar (thesis), Rio de Janeiro (1946)."},{"key":"83587_CR29","doi-asserted-by":"publisher","first-page":"546","DOI":"10.4269\/ajtmh.2011.11-0084","volume":"85","author":"F Bell\u00edssimo-Rodrigues","year":"2011","unstructured":"Bell\u00edssimo-Rodrigues, F., Machado, A. A. & Martinez, R. Paracoccidioidomycosis epidemiological features of a 1000-cases series from a hyperendemic area on the Southeast of Brazil. Am. J. Trop. Med. Hyg. 85, 546\u2013550 (2011).","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"83587_CR30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/jof3010001","volume":"3","author":"R Martinez","year":"2017","unstructured":"Martinez, R. New trends in paracoccidiodomycosis epidemiology. J. Fungi. 3, 1\u201313 (2017).","journal-title":"J. Fungi."},{"issue":"8","key":"83587_CR31","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1111\/myc.12782","volume":"61","author":"SM De Almeida","year":"2018","unstructured":"De Almeida, S. M. et al. Geographical evaluation of neuroparacoccidioidomycosis and paracoccidioidomycosis in Southern Brazil. Mycoses 61(8), 587\u2013593 (2018).","journal-title":"Mycoses"},{"key":"83587_CR32","doi-asserted-by":"publisher","first-page":"4053","DOI":"10.1128\/AEM.00231-09","volume":"75","author":"E Snelders","year":"2009","unstructured":"Snelders, E. et al. Possible environmental origin of resistance of Aspergillus fumigatus to medical triazoles. Appl. Environ. Microbiol. 75, 4053\u20134057 (2009).","journal-title":"Appl. Environ. Microbiol."},{"key":"83587_CR33","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.3389\/fmicb.2017.01024","volume":"08","author":"S Berger","year":"2017","unstructured":"Berger, S. et al. Azole resistance in Aspergillus fumigatus: A consequence of antifungal use in agriculture?. Front. Microbiol. 08, 1024 (2017).","journal-title":"Front. Microbiol."},{"key":"83587_CR34","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1590\/S1806-37132007000300011","volume":"33","author":"JR Quagliato","year":"2007","unstructured":"Quagliato, J. R. et al. Association between paracoccidioidomycosis and tuberculosis: Reality and misdiagnosis. J. Bras. Pneumol. 33, 295\u2013300 (2007).","journal-title":"J. Bras. Pneumol."},{"key":"83587_CR35","first-page":"e0500001","volume":"27","author":"MA Shikanai-Yasuda","year":"2018","unstructured":"Shikanai-Yasuda, M. A. et al. Brazilian guidelines for the clinical management of paracoccidioidomycosis. Epidemiol. Serv. Saude. 27, e0500001 (2018).","journal-title":"Epidemiol. Serv. Saude."},{"key":"83587_CR36","doi-asserted-by":"crossref","unstructured":"Lynch D. P. Oral candidiasis. History, classification, and clinical presentation. Oral Surg. Oral Med. Oral Patholo. 78(2), 189\u201393 (1994).","DOI":"10.1016\/0030-4220(94)90146-5"},{"key":"83587_CR37","doi-asserted-by":"crossref","unstructured":"Bongomin F., Gago S., Oladele R. O. & Denning D.W. Global and multi-national prevalence of fungal diseases-estimate precision. J. Fungi. 3(4), E57 (2017).","DOI":"10.3390\/jof3040057"},{"key":"83587_CR38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1098\/rstb.2015.0468","volume":"371","author":"DW Denning","year":"2016","unstructured":"Denning, D. W. Minimizing fungal disease deaths will allow the UNAIDS target of reducing annual AIDS deaths below 500 000 by 2020 to be realized. Philos. Trans. R. Soc. B. 371, 1\u20139 (2016).","journal-title":"Philos. Trans. R. Soc. B."},{"key":"83587_CR39","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.clp.2014.10.008","volume":"42","author":"SK Matthew","year":"2015","unstructured":"Matthew, S. K., Benjamin, D. K. & Smith, P. B. The epidemiology and diagnosis of invasive candidiasis among premature infants. Clin. Perinatol. 42, 105\u2013117 (2015).","journal-title":"Clin. Perinatol."},{"key":"83587_CR40","first-page":"1199","volume":"8","author":"A Flevari","year":"2013","unstructured":"Flevari, A., Theodorakopoulou, M., Velegraki, A., Armaganidis, A. & Dimopoulos, G. Treatment of invasive candidiasis in the elderly: A review. Clin. Interv. Aging. 8, 1199\u20131208 (2013).","journal-title":"Clin. Interv. Aging."},{"issue":"2","key":"83587_CR41","doi-asserted-by":"publisher","first-page":"S94","DOI":"10.1093\/mmy\/myy081","volume":"57","author":"F Danion","year":"2019","unstructured":"Danion, F. et al. Why are so many cases of invasive aspergillosis missed?. Med. Mycol. 57(2), S94\u2013S103 (2019).","journal-title":"Med. Mycol."},{"key":"83587_CR42","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/S0163-4453(96)92700-0","volume":"33","author":"AH Groll","year":"1996","unstructured":"Groll, A. H. et al. Trends in the post-mortem epidemiology of invasive fungal infection at a University Hospital. J. Infect. 33, 23\u201332 (1996).","journal-title":"J. Infect."},{"key":"83587_CR43","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1111\/myc.12927","volume":"62","author":"EE Tejerina","year":"2019","unstructured":"Tejerina, E. E. et al. Invasive aspergillosis in critically ill patients: An autopsy study. Mycoses 62, 673\u2013679 (2019).","journal-title":"Mycoses"},{"key":"83587_CR44","unstructured":"Barnes, E. A short history of invasive aspergillosis, 1920 to 1965. The Aspergillus website. http:\/\/www.aspergillus.org.uk."},{"key":"83587_CR45","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.idc.2009.10.010","volume":"24","author":"E Catherinot","year":"2010","unstructured":"Catherinot, E. et al. Pneumocystis jirovecii pneumonia. Infect. Dis. Clin. N. Am. 24, 107\u2013138 (2010).","journal-title":"Infect. Dis. Clin. N. Am."},{"issue":"1","key":"83587_CR46","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1111\/j.1550-7408.1989.tb02687.x","volume":"36","author":"PD Walzer","year":"1989","unstructured":"Walzer, P. D. Symposium: Historical perspectives on Pneumocystis carinii. J. Prutozool. 36(1), 39\u201341 (1989).","journal-title":"J. Prutozool."},{"key":"83587_CR47","first-page":"14840","volume":"8","author":"K Ruangritchankul","year":"2015","unstructured":"Ruangritchankul, K. et al. Invasive fungal disease in university hospital: A PCR-based study of autopsy cases. Int. J. Clin. Exp. Pathol. 8, 14840\u201314852 (2015).","journal-title":"Int. J. Clin. Exp. Pathol."},{"key":"83587_CR48","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1002\/yea.2997","volume":"31","author":"D Srikanta","year":"2014","unstructured":"Srikanta, D., Santiago-Tirado, F. H. & Doering, T. L. Cryptococcus neoformans: Historical curiosity to modern pathogen. Yeast 31, 47\u201360 (2014).","journal-title":"Yeast"},{"key":"83587_CR49","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.ijid.2017.08.004","volume":"63","author":"BC Ram\u00edreza","year":"2017","unstructured":"Ram\u00edreza, B. C. et al. Outcomes of HIV-positive patients with cryptococcal meningitis in the Americas. Int. J. Infect. Dis. 63, 57\u201363 (2017).","journal-title":"Int. J. Infect. Dis."},{"key":"83587_CR50","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1093\/mmy\/myu059","volume":"52","author":"RM Pereira","year":"2014","unstructured":"Pereira, R. M. et al. High prevalence of Pneumocystis jirovecii colonization among HIV-positive patients in southern Brazil. Med. Mycol. 52, 804\u2013809 (2014).","journal-title":"Med. Mycol."},{"key":"83587_CR51","first-page":"266","volume":"2","author":"DN Lanjewar","year":"2001","unstructured":"Lanjewar, D. N. & Duggal, R. Pulmonary pathology in patients with AIDS: An autopsy study from Mumbai HIV medicine. Medicine 2, 266\u2013271 (2001).","journal-title":"Medicine"},{"key":"83587_CR52","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.1001\/jama.1906.62510440037003","volume":"46","author":"ST Darling","year":"1906","unstructured":"Darling, S. T. A protozoan general infection producing pseudotuberculosis in the lungs and focal necrosis in the liver, spleen, and lymph nodes. JAMA 46, 1283\u20131285 (1906).","journal-title":"JAMA"},{"key":"83587_CR53","doi-asserted-by":"crossref","unstructured":"Limper A. H., Adenis A., Le. T., Harrison T. S. Fungal infection in HIV\/AIDS. Lancet Infect. Dis. 17(11), e334\u2013e343 (2017).","DOI":"10.1016\/S1473-3099(17)30303-1"},{"key":"83587_CR54","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1046\/j.1439-0507.2003.00956.x","volume":"47","author":"AS Kantarc\u0131og","year":"2004","unstructured":"Kantarc\u0131og, A. S. & Hoog, G. S. Infections of the central nervous system by melanized fungi: A review of cases presented between 1999 and 2004. Mycoses 47, 4\u201313 (2004).","journal-title":"Mycoses"},{"key":"83587_CR55","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1007\/s15010-018-1152-2","volume":"46","author":"K G\u00f3ralska","year":"2018","unstructured":"G\u00f3ralska, K., Blaszkowska, J. & Magdalena, D. M. Neuroinfections caused by fungi. Infection 46, 443\u2013459 (2018).","journal-title":"Infection"},{"key":"83587_CR56","doi-asserted-by":"crossref","unstructured":"Furbringer P. Beobachtungen uber lungenmycose beim menschen. Arch. Pathol. Anat. Physiol. Klin. Med. 66330\u201366365 (1876).","DOI":"10.1515\/9783112398760-027"},{"key":"83587_CR57","doi-asserted-by":"publisher","first-page":"805","DOI":"10.1001\/jama.1957.02970450007003","volume":"163","author":"RD Baker","year":"1957","unstructured":"Baker, R. D. Mucormycosis\u2014A new disease?. JAMA 163, 805\u2013808 (1957).","journal-title":"JAMA"},{"key":"83587_CR58","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1111\/j.1439-0507.2007.01486.x","volume":"51","author":"M Knoke","year":"2008","unstructured":"Knoke, M., Bernhardt, H. & Schwesinger, G. Is there a need for autopsies in the management of fungal disease?. Mycoses 51, 291\u2013300 (2008).","journal-title":"Mycoses"},{"key":"83587_CR59","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/1478-7954-9-25","volume":"9","author":"CL Fligner","year":"2011","unstructured":"Fligner, C. L., Murray, J. & Roberts, D. J. Synergism of verbal autopsy and diagnostic pathology autopsy for improved accuracy of mortality data. Popul. Health Metrics 9, 25 (2011).","journal-title":"Popul. Health Metrics"},{"key":"83587_CR60","doi-asserted-by":"crossref","unstructured":"Dignani, M. C. Epidemiology of invasive fungal diseases on the basis of autopsy reports. F1000Prime Rep. 6(81), 1\u20137 (2014).","DOI":"10.12703\/P6-81"},{"issue":"7418","key":"83587_CR61","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1136\/bmj.327.7418.802","volume":"327","author":"G O'Grady","year":"2003","unstructured":"O\u2019Grady, G. Death of the teaching autopsy. BMJ 327(7418), 802\u2013803 (2003).","journal-title":"BMJ"},{"issue":"3","key":"83587_CR62","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1590\/S1807-59322009000300002","volume":"64","author":"PS Gutierrez","year":"2009","unstructured":"Gutierrez, P. S. et al. The value of necropsy in quality control of medical diagnosis\u2014The gold standard for years to come. Clinics 64(3), 161\u2013162 (2009).","journal-title":"Clinics"},{"key":"83587_CR63","doi-asserted-by":"crossref","unstructured":"Ezaa, D. et al. Postmortem findings and opportunistic infections in HIV-positive patients from a public hospital in Peru. Pathol. Res. Pract. 202, 767\u2013775 (2006).","DOI":"10.1016\/j.prp.2006.07.005"},{"key":"83587_CR64","first-page":"1","volume":"22","author":"P Byass","year":"2016","unstructured":"Byass, P. Minimally invasive autopsy: A new paradigm for understanding global health?. PLoS Med. 22, 1\u20134 (2016).","journal-title":"PLoS Med."},{"key":"83587_CR65","first-page":"1","volume":"20","author":"C Menendez","year":"2017","unstructured":"Menendez, C. et al. Validity of a minimally invasive autopsy for cause of death determination in stillborn babies and neonates in Mozambique: An observational study. PLoS Med. 20, 1\u201317 (2017).","journal-title":"PLoS Med."},{"key":"83587_CR66","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pmed.1002431","volume":"14","author":"P Castillo","year":"2017","unstructured":"Castillo, P. et al. Validity of a minimally invasive autopsy for cause of death determination in maternal deaths in Mozambique: An observational study. PLoS Med. 14, 1\u201317 (2017).","journal-title":"PLoS Med."},{"key":"83587_CR67","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/j.humpath.2018.10.037","volume":"85","author":"F Fernandes","year":"2019","unstructured":"Fernandes, F. et al. Contribution of the clinical information to the accuracy of the minimally invasive and the complete diagnostic autopsy. Hum. Pathol. 85, 184\u2013193 (2019).","journal-title":"Hum. Pathol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-83587-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-83587-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-83587-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,29]],"date-time":"2023-01-29T06:10:33Z","timestamp":1674972633000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-83587-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,17]]},"references-count":67,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["83587"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-83587-1","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,17]]},"assertion":[{"value":"24 August 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 February 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"3943"}}