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Most important infectious diseases which pose a risk to human health and life are associated with parasites transmitted by a variety of arthropod vectors, or from animal to man. Some of these (malaria, toxoplasmosis, leishmaniosis, dirofilariosis, alveococcosis, cystic echinococcosis) still represent a serious public health problem in many regions in the world. This review describes the epidemiological and clinical aspects of important parasitoses and fungal infections from a medical point of view. It should be emphasized that the development of invasive disease depends on both host (susceptibility/resistance) and parasite factors (pathogenicity/virulence); an immunocompromised state can favour opportunistic parasitic infections: toxoplasmosis, cryptosporidiosis, giardiosis, cyclosporidiosis, blastocystosis and strongyloidosis. This article highlights the role of free-living amoebae in the pathogenesis and transmission of human diseases, the high pathogenicity of Echinococcus multilocularis, and the growing importance of ticks as a reservoir and vector for numerous dangerous pathogens (e.g., Borrelia burgdorferi, Anaplasma phagocytophilum, Babesia microti). It also discusses the diagnostic problems of toxoplasmosis including cross-reactions in serological tests and reviews the search for new drugs and vaccines against toxoplasmosis. Attention is increasingly paid to the role played by the human microbiome in maintaining homeostasis and in the development of fungal infections. This review also presents the most common human superficial fungal infections and the role of Candida albicans infection in the pathogenesis of irritable bowel syndrome.

Recent literature data suggests that parasitic and fungal diseases, which pose a threat to both human and animal health, remain a clinical, diagnostic and therapeutic problem. Attention is increasingly paid to the role played by natural microbiota in maintaining homeostasis in humans. A particular emphasis is placed on the possibility of manipulating the human microbiota (permanent, transient, pathogenic) and macrobiota (e.g., Trichuris suis) to support the treatment of selected diseases such as Crohn's disease, obesity, diabetes and cancer. Emphasis is placed on important medical species whose infections not only impair health but can also be life threatening, such as Plasmodium falciparum, Echinococcus multilocularis and Baylisascaris procyonis, which expand into areas which have so far been uninhabited. This article also presents the epidemiology, diagnosis and treatment of opportunistic parasitoses imported from the tropics, which spread across large groups of people through human-to-human transmission (Enterobius vermicularis, Sarcoptes scabiei). It also discusses the problem of environmentally-conditioned parasitoses, particularly their etiological factors associated with food contaminated with invasive forms (Trichinella sp., Toxoplasma gondii). The analysis also concerns the presence of developmental forms of geohelminths (Toxocara sp.) and ectoparasites (ticks), which are vectors of serious human diseases (Lyme borreliosis, anaplasmosis, babesiosis), in the environment. Mycological topics contains rare cases of mycoses environmentally conditioned (CNS aspergillosis) and transmissions of these pathogens in a population of hospitalized individuals, as well as seeking new methods used to treat mycoses.

Background: Fungal infections of the central nervous system (FIs-CNS) have become significantly more common over the past 2 decades. Invasion of the CNS largely depends on the immune status of the host and the virulence of the fungal strain. Infections with fungi cause a significant morbidity in immunocompromised hosts, and the involvement of the CNS may lead to fatal consequences.Methods: One hundred and thirty-five articles on fungal neuroinfection in PubMed, Google Scholar, and Cochrane databases were selected for review using the following search words: “fungi and CNS mycoses”, CNS fungal infections”, “fungal brain infections”, " fungal cerebritis”, fungal meningitis”, “diagnostics of fungal infections”, and “treatment of CNS fungal infections”. All were published in English with the majority in the period 2000-2018. This review focuses on the current knowledge of the epidemiology, clinical presentations, diagnosis, and treatment of selected FIs-CNS.Results: The FIs-CNS can have various clinical presentations, mainly meningitis, encephalitis, hydrocephalus, cerebral abscesses, and stroke syndromes. The etiologic factors of neuroinfections are yeasts (Cryptococcus neoformans, Candida spp., Trichosporon spp.), moniliaceous moulds (Aspergillus spp., Fusarium spp.), Mucoromycetes (Mucor spp., Rhizopus spp.), dimorphic fungi (Blastomyces dermatitidis, Coccidioides spp., Histoplasma capsulatum), and dematiaceous fungi (Cladophialophora bantiana, Exophiala dermatitidis). Their common route of transmission is inhalation or inoculation from trauma or surgery, with subsequent hematogenous or contiguous spread. As the manifestations of FIs-CNS are often non-specific, their diagnosis is very difficult. A fast identification of the etiological factor of neuroinfection and the application of appropriate therapy are crucial in preventing an often fatal outcome. The choice of effective drug depends on its extent of CNS penetration and spectrum of activity. Pharmaceutical formulations of amphotericin B (AmB) (among others, deoxycholate-AmBd and liposomal L-AmB) have relatively limited distribution in the cerebrospinal fluid (CSF); however, their detectable therapeutic concentrations in the CNS makes them recommended drugs for the treatment of cryptococcal meningoencephalitis (AmBd with flucytosine) and CNS candidiasis (L-AmB) and mucormycosis (L-AmB). Voriconazole, a moderately lipophilic molecule with good CNS penetration, is recommended in the first-line therapy of CNS aspergillosis. Other triazoles, such as posaconazole and itraconazole, with negligible concentrations in the CSF are not considered effective drugs for therapy of CNS fungal neuroinfections. In contrast, clinical data have shown that a novel triazole, isavuconazole, achieved considerable efficacy for the treatment of some fungal neuroinfections. Echinocandins with relatively low or undetectable concentrations in the CSF do not play meaningful role in the treatment of FIs-CNS.Conclusion: Although the number of fungal species causing CNS mycosis is increasing, only some possess well-defined treatment standards (e.g., cryptococcal meningitis and CNS aspergillosis). The early diagnosis of fungal infection, accompanied by identification of the etiological factor, is needed to allow the selection of effective therapy in patients with FIs-CNS and limit their high mortality. [ABSTRACT FROM AUTHOR]

Introduction: An increasing number of reports have been issued in the recent years on considerably increased frequency of yeast-like fungi and yeast in organ ontocenoses of man. This applies in particular the respiratory and digestive systems. Aim of the study: The aim of this study was the taxonomical analysis of yeast and yeast-like fungi from the respiratory system and gastrointestinal tract of human with particular emphasis on the number of taxa and attention to the dominant species and rare species in the different sections of studied ontocenosis. Material and methods: The experimental material were yeast-like fungi and yeasts isolated from the respiratory and the digestive system of human. The fungi were cultured and identified following standard principles of mycological diagnostics. Results: The fungi isolated from the respiratory system were classified to 37 species and from the gastrointestinal tract – to 23 species. The predominating species turned out to be the Candida albicans, constituting 19.49% in the respiratory system and 27.87% in the digestive system. Conclusions: Five species have been isolated for the first time in Poland. The abundance of the species detected and the presence of perfect stages in the material examined imply a successive increase in the expansiveness of fungi towards human tissues. Results obtained confirms that the respiratory systems affords the fungi better conditions for the survival and growth. [ABSTRACT FROM AUTHOR]

Introduction: The alimentary tract is colonized very frequently by opportunistic fungi of various systematic and ecophysiological groups, particularly yeasts-like fungi and yeasts. It is not only the reservoir of potential human pathogens but also the path of mycotic invasion and dissemination in many cases leading to fungemia. Aim of study: The study aimed at the detailed taxonomic analysis of fungi isolated from the endoscopic materials and determined in routine tests as yeasts-like fungi. Material and methods: The research material consisted of fungi isolated from the alimentary tract (swabs and specimens) of 45 patients referred to the Endoscopy Laboratory at the Municipal Hospital in Olsztyn. The procedures applied were consistent with the generally accepted diagnostic process applied in mycology laboratories. Specialist keys were used for taxonomic analyses. Results: In total, 70 isolates of fungi belonging to 22 species were obtained, among which as many as 9 species (21% of positive results) had not been previously recorded in Polish gastroenterological literature. Those were: Candida brumptii, Candida dubliniensis, Candida lactis-condensi, Candida pelliculosa, Metchnikovia pulcherrima, Rhodosporidium diobovatum, Saccharomycopsis capsularis, Trichosporon capitatum and Trichosporon fermentans. Conclusions: The taxonomic spectrum of fungi populated the alimentary tract clearly expands - 21% of the fungal community were species new to that ontocenosis. Considering biology and adaptation capacity of fungi, interactions with bacteria and increasing number of iatrogenic factors predisposing for fungal infections, standards of mycological analyses of endoscopic materials should be developed. [ABSTRACT FROM AUTHOR]