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Letícia Aparecida Schiave, Erika Nascimento, Fernando Crivelenti Vilar, Tissiana Marques de Haes, Osvaldo Massaiti Takayanagui, Cristiane Masetto de Gaitani, Roberto Martinez
Fluconazole is extensively used for the treatment of candidiasis and cryptococcosis. Among other factors, successful treatment is related to appropriate fluconazole levels in blood and cerebrospinal fluid. In the present study, fluconazole levels were determined in 15 patients, 14 of whom had AIDS and 13 had neurocryptococcosis. The only selection criterion was treatment with fluconazole, which was performed with a generic or similar form of the drug. Fluconazole level was determined by high performance liquid chromatography and the susceptibility profile of Cryptococcus spp...
January 2018: Brazilian Journal of Infectious Diseases
Sunny Sánchez, Dolores Zambrano, Maylen García, César Bedoya, Carlos Fernández, María Teresa Illnait-Zaragozí
INTRODUCTION: Neurocryptococcosis is an opportunistic fungal infection that represents a high cost in human lives and for the economy of countries. Its causative agent, the Cryptococcus neoformans/Cryptococcus gattii species complex, has a sexual and an asexual phase, four major serotypes and seven molecular varieties with phenotypic, clinical-epidemiological and antifungal susceptibility differences. OBJECTIVE: To characterize by molecular methods clinical isolates of C...
September 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
Luana Rossato, Érico S Loreto, Régis A Zanette, Francieli Chassot, Janio M Santurio, Sydney H Alves
Cryptococcus neoformans is encapsulated yeast that causes cryptococcosis. The cryptococcal meningitis may cause neuropsychiatric symptoms. Here, we evaluated the in vitro activity of amphotericin B (AMB), chlorpromazine (CLOR), and sertraline (SERT) alone or in combination against clinical isolates of C. neoformans considering the capsular induction in vitro. Susceptibility tests were carried out using the broth microdilution method in accordance with the CLSI document M27-A3. The combination [CLOR + AMB] exhibited synergism for 50 and 67 % of strains before capsular induction (group I) and after capsular induction (group II), respectively...
September 2016: Folia Microbiologica
Katia Jaira Galisteu, Luciana Ventura Cardoso, Adriana Antônia da Cruz Furini, Arlindo Schiesari Júnior, Claudia Bernardi Cesarino, Célia Franco, Andrea Regina de Souza Baptista, Ricardo Luiz Dantas Machado
INTRODUCTION: In this study, clinical-laboratory and epidemiological characteristics are described for a group of 700 individuals with HIV (human immunodeficiency virus)/AIDS (acquired immunodeficiency syndrome) in the ART (antiretroviral therapy) era at a teaching hospital that provides a quaternary level of care, with an emphasis on opportunistic infections (OIs), co-infections and immune profile. METHODS: A retrospective cross-sectional study of AIDS cases was conducted from 1998 to 2008 by reviewing medical records from the Base Hospital/FUNFARME (Fundação Faculdade Regional de Medicina), São José do Rio Preto, São Paulo, Brazil...
March 2015: Revista da Sociedade Brasileira de Medicina Tropical
Luís dos Ramos Machado, José Antonio Livramento, Liliana Scaff Vianna
Cerebrospinal fluid (CSF) analysis very frequently makes the difference to the diagnosis, not only in relation to infections but also in other diseases of the nervous system such as inflammatory, demyelinating, neoplastic and degenerative diseases. The authors review some practical and important features of CSF analysis in infectious diseases of the nervous system, with regard to acute bacterial meningitis, herpetic meningoencephalitis, neurotuberculosis, neurocryptococcosis, neurocysticercosis and neurosyphilis...
September 2013: Arquivos de Neuro-psiquiatria
Antônio O F da Silva, Luciano Z Goldani
The use of highly active antiretroviral therapy (HAART) has significantly reduced the incidence and progression of HIV-associated cryptococcosis. However, an early complication of HAART is the immune reconstitution inflammatory syndrome (IRIS), which may affect the CNS. The authors report a patient successfully treated for cryptococcosis and HIV who presented a late manifestation of IRIS. Neuroimaging aspects and management of CNS-IRIS in this patient are discussed in this paper.
2013: Case Reports in Radiology
Patricia Escandón, Catalina de Bedout, Jairo Lizarazo, Clara Inés Agudelo, Angela Tobón, Solmara Bello, Angela Restrepo, Elizabeth Castañeda
INTRODUCTION: A survey on cryptococcosis is being conducted regularly in Colombia since 1997. We present hereby the results corresponding to patients diagnosed from 2006 to 2010. OBJECTIVE: To analyze the data obtained during this period. MATERIALS AND METHODS: Retrospective analysis of the corresponding surveys. RESULTS: A total of 526 surveys originating from 72% of the Colombian political divisions were received during the 5-year period...
September 2012: Biomédica: Revista del Instituto Nacional de Salud
Katya C Rocha, Cinthia Pinhal, Sônia Cavalcanti, Monica S M Vidal, Matheus Toscano, Dewton Moraes-Vasconcelos, Alberto J S Duarte, Fernando L A Fonseca, Luiz Carlos de Abreu, Vitor E Valenti, Anete S G Grumach
BACKGROUND: Cryptococcus neoformans causes meningitis and disseminated infection in healthy individuals, but more commonly in hosts with defective immune responses. Cell-mediated immunity is an important component of the immune response to a great variety of infections, including yeast infections. We aimed to evaluate a specific lymphocyte transformation assay to Cryptococcus neoformans in order to identify immunodeficiency associated to neurocryptococcosis (NCC) as primary cause of the mycosis...
2012: BMC Infectious Diseases
Anne Debourgogne, Ferry Hagen, Narcisse Elenga, Laurence Long, Denis Blanchet, Vincent Veron, Olivier Lortholary, Bernard Carme, Christine Aznar
Compared to the incidence in adults, cryptococcosis is rare among children. We report a case of neurocryptococcosis due to Cryptococcus gattii in a five-year-old girl without identified risk factors living in French Guiana. Neurological surgery in combination with long-term antifungal treatment with amphotericin B and 5-flucytosine successfully resolved the cryptococcal infection. Subsequent molecular characterization of the Cryptococcus isolate revealed that the infection was caused by a C. gattii genotype AFLP6B/VGIIb strain...
October 2012: Revista Iberoamericana de Micología
Diego Rodrigues Falci, Luciano Weber Lunardi, Carina Guedes Ramos, Mônica Baumgardt Bay, Valério Rodrigues Aquino, Luciano Zubaran Goldani
We measured fungicidal activity of continuous infusion of amphotericin B deoxycholate plus 5'flucytosine using quantitative cultures of cerebrospinal fluid (CSF) obtained from lumbar punctures of human immunodeficiency virus (HIV)-infected patients with neurocryptococcosis during 14 days of treatment. Glomerular renal function was preserved in all patients. Mycological efficacy with progressive reduction in CSF cryptococcal colony-forming units was comparable to standard 4-h infusion of amphotericin B.
March 1, 2010: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Patrick O Eghwrudjakpor, Akaribara B Allison
We report an unusual case of a 10-year-old girl with neurocryptococcosis that was diagnosed only after histological examination of the cyst fluid obtained at surgery.
June 2009: Acta Neurochirurgica
Marcelo Corti, Maria Florencia Villafañe, Ricardo Negroni, Alicia Arechavala, Elena Maiolo
Cryptococcosis is an opportunistic fungal infection caused by Cryptococcus neoformans. Generally, the disease affects the central nervous system, especially in patients with human immunodeficiency virus infection. Central nervous system involvement can be either meningeal or parenchymal. As the infection spreads along the Virchow-Robin spaces these structures may dilate with the mucoid and gelatinous material produced by the organism's capsule. The lesions associated with the dilatation of Virchow-Robin spaces are referred to as gelatinous pseudocysts...
December 31, 2008: Revista Iberoamericana de Micología
Clóvis Klock, Marselle Cerski, Luciano Z Goldani
The authors describe the histopathological necropsy findings of 45 human immunodeficiency virus (HIV)-infected patients with neurocryptococcosis. Systemic cryptococcosis with involvement of multiple organs such as spleen, liver, and lungs was present in all patients. Predominant diffuse meningoencephalitis predominantly in the basal ganglia, thalamus, and mid-brain, with minimal inflammatory infiltrate was seen in 30 AIDS patients (70%). We frequently observed in those patients the presence of multiple gelatinous pseudocysts with abundant Cryptococcus neoformans in the Virchow-Robin spaces and adjacent brain caused by the dissemination of the meningeal infection along the perivascular spaces...
December 2009: International Journal of Surgical Pathology
L T Santamaria Saber, M Y Ikeda, J M Almeida
Sirolimus (SRL) has become an option in kidney transplantation, especially among patients who develop chronic allograft nephropathy (CAN). This study sought to evaluate the safety and efficacy of SRL in 103 kidney recipients of mean age 40 years, including 78 recipients of organs from deceased donors. The major reason for conversion was calcineurin inhibitor (CNI) nephrotoxicity (42.3%) followed by CAN (35.4%). A preconversion kidney biopsy was performed in 89 patients with CAN diagnosed in 51. Mean time to conversion was 40...
December 2007: Transplantation Proceedings
A E Kouame-Assouan, P Cowppli-Bony, E Aka-Anghui Diarra, B Assi, M Doumbia, L Diallo, K C Adjien, E Akani, T Sonan, M Diagana, Y E Boa, B Kouassi
The usual clinical expression of neuromeningeal cryptococcosis is a meningoencephalitis. We report two cases of neurocryptococcosis which have been revealed by an unusual clinical aspect: an ischemic stroke with a vasculitis mechanism. The two patients had a positive reaction for the HIV and we discussed the responsibility of the HIV or the Cryptococcus in the occurrence of the cerebral infarct.
February 2007: Bulletin de la Société de Pathologie Exotique
Regina Célia Paschoal, Mário Hiroyuki Hirata, Rosário Crespo Hirata, Márcia de Souza Carvalho Melhem, Amanda Latercia Tranches Dias, Claudete Rodrigues Paula
Cryptococcus neoformans detection was optimized using PCR technique with the objective of application in the clinical laboratory diagnosis. The amplification area was ITS and 5,6S which encodes the ribosomal RNA (rRNA). A total of 72 cerebrospinal fluid (CSF) samples were used, obtained from cases with and without AIDS. The patients had cryptococcal meningitis (n = 56) and meningitis caused by other agents (n = 16). The results demonstrated that PCR test had the highest sensitivity rates, superior to culture (85...
July 2004: Revista do Instituto de Medicina Tropical de São Paulo
O de F Fernandes, T R Costa, M R Costa, A J Soares, A J Pereira, M do R Silva
Cryptococcosis is considered the most frequent fungal systemic opportunist infection in patients with AIDS. C. neoformans var. neoformans infects the patients with AIDS more often than C. neoformans var. gattii which has been rarely isolated from patients with AIDS. Even in endemic regions of C. neoformans var. gattii, the variety of neoformans is still the most common agent diagnosed in cryptococcosis of patients with AIDS. Cerebrospinal fluid (CSF) from fifty patients with neurocryptococcosis associated with AIDS were studied...
January 2000: Revista da Sociedade Brasileira de Medicina Tropical
M S Batista, R C Sesso, J B dos Reis-Filho
We reviewed the cerebrospinal fluid (CSF) syndromes of 100 consecutive HIV-positive patients presenting acute consciousness compromise in emergency rooms, and correlated them with clinical data. The most frequent CSF syndromes were: absolute protein-cytological dissociation (21), viral (19), neurocryptococcosis (7), relative protein-cytological dissociation (6) and septic (4), moderate hypoglycorrachia (4), severe hypoglycorrachia (4) and hydroelectrolytic disturbance (3). One fifth of the patients had CSF syndromes considered sufficient for diagnosis or an immediate clinical decision...
November 1999: Revista da Sociedade Brasileira de Medicina Tropical
A Nucci, J A Maciel Júnior, L de S Queiroz, M A Montenegro, R B De Carvalho
We report a case of neurocryptococcosis which is unique in the literature because the patient had a pseudocystic form of the disease during pregnancy and without any evidence of AIDS. The clinical picture was that of intracranial hypertension and the epidemiological background was highly suggestive of cysticercosis. CT showed multiple round hypodense lesions in the basal ganglia and cerebellum, without contrast enhancement. Since a scolex was not visible, the diagnosis of neurocysticercosis was considered probable...
September 1999: Arquivos de Neuro-psiquiatria
C R Garlipp, C L Rossi, P V Bottini
Cryptococcosis is one of the most common fungal infections of the central nervous system (CNS) in AIDS patients and meningoencephalitis or meningitis is a frequently observed manifestation. However, systematic studies of cerebrospinal fluid (CSF) composition from AIDS patients with CNS cryptococcosis have been few. CSF samples from 114 HIV seropositive patients whose clinical complaint suggested CNS involvement, were analyzed; 32 samples from patients diagnosed as having neurocryptococcosis (Group 1) and 82 samples from patients with no identified neurological disfunction (Group 2)...
November 1997: Revista do Instituto de Medicina Tropical de São Paulo
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