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Management is difficult due to paucity of evidence, limited CNS penetration of antifungal agents and their significant toxicity. It is important to identify the causative organism due to highly variable susceptibility profiles. Treatment success is primarily evaluated based on symptom improvement. This review aims to arm clinicians with the broad knowledge required to diagnose and treat these rare, yet important, conditions with significant clinical consequences.<\/jats:p>","DOI":"10.1136\/pn-2026-005263","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:20:28Z","timestamp":1791220828000},"page":"pn-2026-005263","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Neuromycoses: recognition and management in clinical practice"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4848-6156","authenticated-orcid":false,"given":"Michael","family":"Trubshaw","sequence":"first","affiliation":[{"name":"Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maeve","family":"Barlow","sequence":"additional","affiliation":[{"name":"Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"University College London Institute for Global Health, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila","family":"Nagoda Niklewicz","sequence":"additional","affiliation":[{"name":"Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvaro","family":"Sanchez Martinez","sequence":"additional","affiliation":[{"name":"Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Parker","sequence":"additional","affiliation":[{"name":"Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Montes","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Tropical \u2018Alexander von Humboldt\u2019, Universidad Peruana Cayetano Heredia, Lima District, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Waters","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Etobicoke General Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"Arts","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"McNamara","sequence":"additional","affiliation":[{"name":"National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Stone","sequence":"additional","affiliation":[{"name":"Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"2026100610202350000_pn-2026-005263v2.1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-018-1152-2"},{"key":"2026100610202350000_pn-2026-005263v2.2","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1177\/1352458519877810","article-title":"The long-term outcomes of CIS patients in the Barcelona inception cohort: Looking back to recognize aggressive MS","volume":"26","author":"Tintore","year":"2020","journal-title":"Mult Scler"},{"key":"2026100610202350000_pn-2026-005263v2.3","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2016.00292","article-title":"Fungal Infection in the Brain: What We Learned from Intravital Imaging","volume":"7","author":"Shi","year":"2016","journal-title":"Front Immunol"},{"key":"2026100610202350000_pn-2026-005263v2.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.mib.2020.07.011"},{"key":"2026100610202350000_pn-2026-005263v2.5","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1080\/21505594.2016.1261789","article-title":"Role of microglia in fungal infections of the central nervous system","volume":"8","author":"Koutsouras","year":"2017","journal-title":"Virulence"},{"key":"2026100610202350000_pn-2026-005263v2.6","doi-asserted-by":"crossref","unstructured":"Murthy JMK , Sundaram C . 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