title: Fungal infections as a contributing cause of death: an autopsy study.
abstract: BACKGROUND
  With the continuing rise in the number of immunocompromised patients, the incidence of invasive mycoses has increased. Various studies have reported the trends of fungal infections in autopsies. Because of limitations in antemortem clinical diagnosis owing to lack of sensitive diagnostic tools, information regarding frequency and pathogenesis of fungal infections is largely dependent on autopsy studies.
  
  
  OBJECTIVE
  To study the prevalence of fungal infections at autopsy spanning a period of 20 years and to document recent trends, prevalence of various fungi over decades along with underlying predisposing factors and pathological findings.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  All autopsies between 1988 and 2007 were reviewed and all cases showing fungal infections were analyzed. The clinical details and demographic data were retrieved from medical records. Representative sections from all organs were stained with hematoxylin and eosin stain and special stains including Gomori's silver methenamine (GMS) and periodic acid Schiff (PAS). Culture details were noted, wherever available.
  
  
  RESULTS
  A total of 401 autopsies were performed during the study period. Fungal infections were identified in 35 (8.7%) of these cases. Leukemia was the commonest risk factor. The commonest pathogen in the present study was Aspergillus sp. The commonest single organ involved was brain (n = 18). Culture positivity was seen in 23.8% cases.
  
  
  CONCLUSIONS
  The study highlights various predisposing factors and organisms in autopsy series. Existing diagnostic modalities are not sensitive to ensure antemortem diagnosis of fungal infections.
authors.affiliation: Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India.
authors.forename: Megha S
authors.initials: MS
authors.lastname: Uppin
authors.forename: S V N
authors.initials: SV
authors.lastname: Anuradha
authors.forename: Shantveer G
authors.initials: SG
authors.lastname: Uppin
authors.forename: Tara Roshni
authors.initials: TR
authors.lastname: Paul
authors.forename: Aruna K
authors.initials: AK
authors.lastname: Prayaga
authors.forename: C
authors.initials: C
authors.lastname: Sundaram
mesh_terms: D000293:Adolescent; D000328:Adult; D001344:Autopsy; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D005658:Fungi / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis* / Q000382:microbiology / Q000401:mortality*; D012189:Retrospective Studies; D055815:Young Adult