Early diagnosis may be achieved by high index of suspicion, neuroimaging, stereotactic brain biopsy, and use galactomannan in serum and cerebrospinal fluid. Whole genome sequencing and detection of cell free nucleic acid can improve diagnostic capabilities. Surgical debridement of infected tissue will reduce disease burden and allow enhanced antifungal drug penetration. Voriconazole, posaconazole, and isavuconazole are recommended as primary therapy, and therapeutic drug monitoring guided higher doses of azoles may improve outcomes. Olorofim and fosmanogepix are promising agents for the future.
Soman et al. (Fri,) studied this question.