A diverse spectrum of mycoses histologically diagnosed in Ghana: Insights from a 10-year retrospective study

In Ghana, most laboratory diagnoses of se v ere m y coses are based on histopathology findings due to inadequate a v ailability of serology, culture, and molecular tests. The aim of this study was to evaluate the spectrum of mycoses diagnosed in Ghana. We retrospectively reviewed reports from 2012 to 2021 from three major pathology laboratories in Ghana to identify reports indicating the presence of fungal elements and diagnosis of a m y cosis, then e xtracted demographic, clinical history, site of infection, stain(s), used and diagnosed m y cosis details. Ov er the 10-y ear period, 107 cases were found. No apparent increasing and decreasing trend in the number of cases per year or in a period was observed. The age range of affected patients was from 4 to 86 years. Special stains for fungi were only used in 22 of 107 (20.6%) of cases. The most frequently affected site was the sino-nasal area (34%). Mycosis type was determined for 58 (54.2%) cases, comprising aspergillosis (21), candidiasis (14), dermatophytosis (6), mucormycosis (3), two cases each of chromoblastom y cosis, histoplasmosis, eum y cetoma, entomophthorom y cosis, sporotrichosis, and Malassezia infection and a single case each of cryptococcosis and deep on y chom y cosis. Of the 53 (49.5%) cases with presumptive diagnosis data, only seven (13.2%) had a pre-biopsy suspicion of mycosis. There is a wide spectrum of mycoses in Ghana, including endemic m y coses not pre viously reported. Impro ving the use of special fungal stains could increase yield and m y coses identification. Laboratory diagnostic capacity needs enhancement to complement histopathology in v estigations with serology, culture, and molecular methods.