Emerging Fungal Infections of the Central Nervous System in the Past Decade: A Literature Review

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Dear all,

 

Thank you for sending this review. I find the focus on unconventional fungal infections in the central nervous system (CNS) to be quite relevant, and the paper's structure resembles that of a book chapter.

 

I believe there are three key points that could enhance the work:

 

- Methodology

The beginning of the methodology section suggests that the paper follows a systematic review approach with a rigorous selection method. However, a passage needs to be clarified regarding the nature of the review: "An extensive list of 28 fungi was selected. Articles were screened to identify emerging fungi causing CNS infections based on the following criteria: increased incidence, expanding or shifting geographical distribution, and evidence of multiple reports of CNS involvement. Fungi previously established as well-known important causes of CNS infection, with no evidence of disproportionate increase in the number of infections in the last ten years, or that showed no apparent potential to become a major health concern were excluded. A final group of 7 fungi was selected...".

 

This description gives the impression of being a narrative review, as some of the selection criteria are somewhat subjective. I recommend revising the methodology to clarify whether it is a narrative or systematic review. If it is a systematic review, it would be essential to demonstrate the scientific rigor and detailed process of article selectionmore clearly.

 

- Table

The table presented is one of the highlights of the article, but it could be clearer and easier to read. I suggest some adjustments to improve the presentation of the content. For example, short words like "Morphology" could be arranged vertically at 90 degrees, reducing the space for this column and increasing the space available for fields with more extensive text. Additionally, it would be helpful to synthesize the information to make the table clearerand more accessible.

 

-Conclusion

Another important aspect is the need to clearly establish this study's limitations in the conclusion. Since few studies are available, and these are often based on case reports, it is often challenging to find technical support in the literature for the best approach in cases of unconventional fungal infections in the CNS. As a result, decisions are often made based on expert opinion, and this material aims to assist in decision-making under these circumstances.

 

In summary, this is a relevant piece on unconventional fungi in the CNS that would benefit from methodological improvements.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Editor

Thank you for inviting me to review the article entitled Emerging fungal infections of the Central Nervous System in 2 the Past Decade: a literature review

The authors' review was extensive and used important articles. The construction of the article is confusing. I believe that the authors could simplify some information that is repeated in each theme in tables respecting the scope of the journal.

Please check the correct presentation of the methodology of a systematic review. I believe that it is possible to improve.

The discussion of the article for a review of this size should be more in-depth and well-founded.

The review proposal is important, but the presentation is not in line with expectations.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The authors have put in meticulous and commendable efforts in compiling all the information for this review. The review is scientifically engaging and a good source of literature for the associated scientific fraternity.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Dear Authors,

I am pleased to inform you that all the requested revisions have been made. The article is now more robust and clearer in its review proposal. I believe the manuscript offers significant contributions to the understanding of unconventional fungal infections in the central nervous system (CNS).

Sincerely,

Author Response

Comments: I am pleased to inform you that all the requested revisions have been made. The article is now more robust and clearer in its review proposal. I believe the manuscript offers significant contributions to the understanding of unconventional fungal infections in the central nervous system (CNS).

Response: Thank you very much for taking the time to review this manuscript. We really appreciated all your comments and suggestions that greatly contributed to the improvement of the work. 

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Authors,

The changes were made as requested. I have a small observation: please review Table 1, including the topic on geographic distribution. Especially the reference on Sporothrix spp.

Author Response

Comments: The changes were made as requested. I have a small observation: please review Table 1, including the topic on geographic distribution. Especially the reference on Sporothrix spp.

Response: Thank you for taking the time to review this article and for all the useful remarks. Regarding the geographic distribution in Table 1, thank you so much for pointing this mistake out. We have consequentely corrected the part of the Sporothrix spp geographic distribution in Table 1, in accordance also with what is written in the text.