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Cryptococcal meningitis

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https://www.readbyqxmd.com/read/29466605/continuous-sheath-free-separation-of-drug-treated-human-fungal-pathogen-cryptococcus-neoformans-by-morphology-in-biocompatible-polymer-solutions
#1
Di Li, Jessica Zielinski, Lukasz Kozubowski, Xiangchun Xuan
Cryptococcal meningitis caused by Cryptococcus neoformans is the leading cause of fungal central nervous system infections. Current antifungal treatments for cryptococcal infections are inadequate partly due to the occurrence of drug resistance. Recent studies indicate that the treatment of the azole drug fluconazole changes the morphology of C. neoformans to form enlarged "multimeras" that consist of three or more connected cells/buds. To analyze if these multimeric cells are a prerequisite for C...
February 21, 2018: Electrophoresis
https://www.readbyqxmd.com/read/29456239/a-rare-presentation-of-cryptococcal-meningitis-and-cerebellitis-in-an-asplenic-patient-seronegative-for-human-immunodeficiency-virus-hiv
#2
Hafsa Abbas, Angelica CiFuentes Kottkamp, Naeem Abbas, Richard Cindrich, Manisha Singh
BACKGROUND Cryptococcal meningitis in patients who are seronegative for the human immunodeficiency virus (HIV) and in patients who are splenectomized is rare. This report is an unusual case of meningeal and cerebellar infection due to the encapsulated yeast, Cryptococcus neoformans, which has not previously been associated with asplenia. CASE REPORT A 65-year-old HIV-negative patient with a previous splenectomy, presented with a three-day history of fever, vomiting, and headache. His symptoms progressed to generalized body aches, persistent fever, and neck stiffness...
February 19, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29451598/performance-of-cryptococcal-antigen-lateral-flow-assay-in-serum-cerebrospinal-fluid-whole-blood-and-urine-in-hiv-infected-patients-with-culture-proven-cryptococcal-meningitis-admitted-at-a-brazilian-referral-center
#3
José E Vidal, Carolina Toniolo, Adriana Paulino, Arnaldo L Colombo, Marilena Dos Anjos Martins, Cristina da Silva Meira, Renata Guise Soares Azevedo, Vera Lucia Pereira-Chioccola, Hélio Rodrigues Gomes, Marcia Dos Santos Lazera, Augusto C Penalva de Oliveira, David R Boulware
Cryptococcal meningitis is the most common cause of opportunistic meningitis in HIV-infected patients in Brazil and causes unacceptable high mortality rates. In this study, HIV-infected patients with a first episode of culture-proven cryptococcal meningitis in cerebrospinal fluid (CSF) were prospectively included in order to evaluate sensitivity of cryptococcal antigen (CrAg) lateral flow assay (LFA) in serum, CSF, whole blood (fingerstick), and fresh urine. In addition, HIV-infected patients with other neurological confirmed diseases were included in order to evaluate the specificity of CrAg LFA in serum...
2018: Revista do Instituto de Medicina Tropical de São Paulo
https://www.readbyqxmd.com/read/29432047/community-acquired-meningitis-in-hiv-infected-patients-in-the-united-states
#4
Karen J Vigil, Lucrecia Salazar, Rodrigo Hasbun
We conducted a retrospective study of 549 adults admitted with community-acquired meningitis (CAM) to several hospitals in New Orleans, LA and Houston, TX between 1999 and 2014 to characterize the current epidemiology, clinical manifestations, cerebrospinal fluid (CSF) characteristics, and outcomes of CAM between HIV-infected and uninfected patients and to identify risk factors for adverse outcomes in CAM. Bivariate analysis and logistic regression analysis were used to identify prognostic factors. A total of 1022 patients with CAM were screened...
February 2018: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/29423423/rapid-reversal-of-complete-binocular-blindness-with-high-dose-corticosteroids-and-lumbar-drain-in-a-solid-organ-transplant-recipient-with-cryptococcal-meningitis-and-immune-reconstitution-syndrome-first-case-study-and-literature-review
#5
Zoe Weiss, Nihaal Mehta, Su Nandar Aung, Michael Migliori, Dimitrios Farmakiotis
Blindness is a rare, devastating, usually permanent complication of cryptococcal meningitis (CM). We present the first case of complete vision loss in a solid organ transplant recipient with CM treated with placement of a lumbar drain who had a dramatic visual recovery that started after 3 doses of high-dose steroids.
February 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29420767/evaluation-of-trypan-blue-stain-in-the-tc20-automated-cell-counter-as-a-point-of-care-for-the-enumeration-of-viable-cryptococcal-cells-in-cerebrospinal-fluid
#6
Richard Kwizera, Andrew Akampurira, Tadeo K Kandole, Maria S Nabaggala, Darlisha A Williams, Andrew Kambugu, David B Meya, Joshua Rhein, David R Boulware
Cerebrospinal fluid (CSF) culture can determine a quantitative viability of Cryptococcus yeasts; however, culture has a long turnaround-time. The TC20 automated cell counter (Bio-Rad) is a benchtop instrument used to count cells in 30 seconds. In vitro studies suggest trypan blue staining can distinguish between viable and dead cryptococcal yeasts. We hypothesized that trypan blue staining with automated cell counting may provide rapid quantification of viable CSF Cryptococcus yeasts. In sum, 96 HIV-infected participants with cryptococcal meningitis were enrolled and provided 194 CSF specimens in Kampala, Uganda...
October 9, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/29382737/udp-glucuronic-acid-transport-is-required-for-virulence-of-cryptococcus-neoformans
#7
Lucy X Li, Carsten Rautengarten, Joshua L Heazlewood, Tamara L Doering
Glycans play diverse biological roles, ranging from structural and regulatory functions to mediating cellular interactions. For pathogens, they are also often required for virulence and survival in the host. In Cryptococcus neoformans, an opportunistic pathogen of humans, the acidic monosaccharide glucuronic acid (GlcA) is a critical component of multiple essential glycoconjugates. One of these glycoconjugates is the polysaccharide capsule, a major virulence factor that enables this yeast to modulate the host immune response and resist antimicrobial defenses...
January 30, 2018: MBio
https://www.readbyqxmd.com/read/29379704/paradoxical-respiratory-failure-due-to-cryptococcal-pneumonia-after-amphotericin-b-treatment-for-hiv-associated-cryptococcal-meningitis
#8
James E Scriven, Francois Cj Botha, Charlotte Schutz, David G Lalloo, Helen Wainwright, Graeme Meintjes
We present a 27-year-old lady with HIV-1 infection who died due to rapidly worsening respiratory failure one day after commencing amphotericin B deoxycholate therapy for cryptococcal meningitis. Chest x-ray appearances were consistent with pneumocystis pneumonia but post mortem examination showed evidence of severe necrotizing cryptococcal pneumonia. Cryptococcal pneumonia is an underrecognized condition and should be considered in the differential of patients with HIV-1 infection and low CD4 count who develop respiratory symptoms...
March 2018: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/29377368/a-systematic-review-of-fluconazole-resistance-in-clinical-isolates-of-cryptococcus-species
#9
REVIEW
Felix Bongomin, Rita O Oladele, Sara Gago, Caroline B Moore, Malcolm D Richardson
Fluconazole is the most commonly used antifungal agent for both the treatment of cryptococcal meningitis, and for prophylaxis against the disease. However, its prolonged use has the potential to exert selection pressure in favour of fluconazole-resistant strains. We evaluated the prevalence of fluconazole resistance of Cryptococcus spp. clinical isolates in 29 studies from 1988 to May 2017 included in EMBASE and MEDLINE databases. A total of 4,995 Cryptococcus isolates from 3,210 patients constituted this study; 248 (5...
January 29, 2018: Mycoses
https://www.readbyqxmd.com/read/29374632/cryptococcal-meningitis-in-a-daily-cannabis-smoker-without-evidence-of-immunodeficiency
#10
Bryan B Shapiro, Rebecca Hedrick, Brigitte C Vanle, Courtney A Becker, Chris Nguyen, David M Underhill, Margie A Morgan, Joel D Kopple, Itai Danovitch, Waguih William IsHak
Cryptococcal meningitis is a life-threatening condition most commonly observed in immunocompromised individuals. We describe a daily cannabis smoker without evidence of immunodeficiency presenting with confirmed Cryptococcus neoformans meningitis. An investigation of cannabis samples from the patient's preferred dispensary demonstrated contamination with several varieties of Cryptococcus, including C. neoformans, and other opportunistic fungi. These findings raise concern regarding the safety of dispensary-grade cannabis, even in immunocompetent users...
January 26, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29373741/high-rates-of-cerebral-toxoplasmosis-in-hiv-patients-presenting-with-meningitis-in-accra-ghana
#11
Japheth A Opintan, Benedict K Awadzi, Isaac J K Biney, Vincent Ganu, Richard Doe, Ernest Kenu, Rita F Adu, Mary M Osei, Amos Akumwena, Michael E Grigg, Gary A Fahle, Mercy J Newman, Peter R Williamson, Margaret Lartey
Background: Data on adult meningitis among patients infected with the human immunodeficiency virus (HIV) is scarce in western sub-Saharan Africa, including Ghana. Methods: HIV-infected adults with a provisional diagnosis of meningitis were consecutively enrolled, between August 2014 and January 2016. After patient data collection, cerebrospinal fluid (CSF) was obtained and evaluated for microbiological aetiologies, cell counts and biochemistry. Caregiver clinicians provided limited data for inpatients at the end-point of discharge or death...
January 24, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29371581/hiv-associated-cryptococcal-disease-in-resource-limited-settings-a-case-for-prevention-is-better-than-cure
#12
REVIEW
Rita O Oladele, Felix Bongomin, Sara Gago, David W Denning
Cryptococcal disease remains a significant source of global morbidity and mortality for people living with HIV, especially in resource-limited settings. The recently updated estimate of cryptococcal disease revealed a global incidence of 223,100 cases annually with 73% of these cases being diagnosed in sub-Saharan Africa. Furthermore, 75% of the estimated 181,100 deaths associated with cryptococcal disease occur in sub-Saharan Africa. Point-of-care diagnostic assays have revolutionised the diagnosis of this deadly opportunistic infection...
December 2, 2017: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29371573/global-and-multi-national-prevalence-of-fungal-diseases-estimate-precision
#13
REVIEW
Felix Bongomin, Sara Gago, Rita O Oladele, David W Denning
Fungal diseases kill more than 1.5 million and affect over a billion people. However, they are still a neglected topic by public health authorities even though most deaths from fungal diseases are avoidable. Serious fungal infections occur as a consequence of other health problems including asthma, AIDS, cancer, organ transplantation and corticosteroid therapies. Early accurate diagnosis allows prompt antifungal therapy; however this is often delayed or unavailable leading to death, serious chronic illness or blindness...
October 18, 2017: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29371546/monocyte-phenotype-and-ifn-%C3%AE-inducible-cytokine-responses-are-associated-with-cryptococcal-immune-reconstitution-inflammatory-syndrome
#14
David B Meya, Samuel Okurut, Godfrey Zziwa, Stephen Cose, Paul R Bohjanen, Harriet Mayanja-Kizza, Moses Joloba, David R Boulware, Carol Yukari Manabe, Sharon Wahl, Edward N Janoff
A third of adults with AIDS and cryptococcal meningitis (CM) develop immune reconstitution inflammatory syndrome (IRIS) after initiating antiretroviral therapy (ART), which is thought to result from exaggerated inflammatory antigen-specific T cell responses. The contribution of monocytes to the immunopathogenesis of cryptococcal IRIS remains unclear. We compared monocyte subset frequencies and immune responses in HIV-infected Ugandans at time of CM diagnosis (IRIS-Baseline) for those who later developed CM-IRIS, controls who did not develop CM-IRIS (Control-Baseline) at CM-IRIS (IRIS-Event), and for controls at a time point matched for ART duration (Control-Event) to understand the association of monocyte distribution and immune responses with cryptococcal IRIS...
June 2, 2017: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29371497/neuro-immune-mechanisms-of-anti-cryptococcal-protection
#15
REVIEW
Rebecca A Drummond
Cryptococcal meningitis (CM) is a life-threatening fungal disease affecting both immunosuppressed and immunocompetent people. The main causative agent of CM is Cryptococcus neoformans, a basidiomycete fungus prevalent in the environment. Our understanding of the immune mechanisms controlling C. neoformans growth within the central nervous system (CNS) is poor. However, there have been several recent advances in the field of neuroimmunology regarding how cells resident within the CNS, such as microglia and neurons, can participate in immune surveillance and control of infection...
December 25, 2017: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29357302/role-of-the-inositol-pyrophosphate-multikinase-kcs1-in-cryptococcus-inositol-metabolism
#16
Guojian Liao, Yina Wang, Tong-Bao Liu, Gurkirat Kohli, Weidong Qian, Erika Shor, Selvakumar Subbian, Chaoyang Xue
Cryptococcus neoformans is the most common cause of deadly fungal meningitis. This fungus has a complex inositol acquisition and utilization system, and our previous studies have shown the importance of inositol utilization in cryptococcal development and virulence. However, how inositol utilization is regulated in this fungus remains unknown. In this study, we found that inositol, irrespective of the presence of glucose in the media, represses the expression of C. neoformans genes involved in inositol pyrophosphate biosynthesis, including the gene encoding inositol hexakisphosphate kinase Kcs1...
January 18, 2018: Fungal Genetics and Biology: FG & B
https://www.readbyqxmd.com/read/29353491/enhanced-fluconazole-consolidation-therapy-for-cryptococcal-meningitis-in-sub-saharan-africa-much-to-gain-little-to-lose
#17
Richard Andrew Murphy, Timothy Hatlen, Mahomed-Yunus Moosa
Cryptococcal meningitis accounts for an estimated 25% of acquired immunodeficiency syndrome (AIDS)-associated mortality in sub-Saharan Africa. Accumulating animal and accumulating human evidence suggest that a higher, more fungicidal, dose of fluconazole during consolidation therapy could be more effective in controlling residual infection and may help significantly reduce post-hospitalization mortality. Although the potential for toxicity is low, the use of fluconazole at a dose of 800 mg/day during consolidation therapy requires examination in a randomized clinical trial...
January 21, 2018: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/29346417/xylose-donor-transport-is-critical-for-fungal-virulence
#18
Lucy X Li, Carsten Rautengarten, Joshua L Heazlewood, Tamara L Doering
Cryptococcus neoformans, an AIDS-defining opportunistic pathogen, is the leading cause of fungal meningitis worldwide and is responsible for hundreds of thousands of deaths annually. Cryptococcal glycans are required for fungal survival in the host and for pathogenesis. Most glycans are made in the secretory pathway, although the activated precursors for their synthesis, nucleotide sugars, are made primarily in the cytosol. Nucleotide sugar transporters are membrane proteins that solve this topological problem, by exchanging nucleotide sugars for the corresponding nucleoside phosphates...
January 2018: PLoS Pathogens
https://www.readbyqxmd.com/read/29322063/neurological-sequelae-of-adult-meningitis-in-africa-a-systematic-literature-review
#19
REVIEW
Drew W Goldberg, Mark W Tenforde, Hannah K Mitchell, Joseph N Jarvis
The high human immunodeficiency virus (HIV) prevalence in sub-Saharan Africa has markedly changed the epidemiology and presentation of adult meningitis. We conducted a systematic review using PubMed, Embase, Ovid, CENTRAL, and African Index Medicus to identify studies in Africa with data on neurological outcomes in adults after meningitis. We found 22 articles meeting inclusion criteria. From 4 studies with predominately pneumococcal meningitis, a median of 19% of survivors experienced hearing loss up to 40 days...
January 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29319242/clinical-diversity-of-cns-cryptococcosis
#20
J M Koshy, S Mohan, D Deodhar, M John, A Oberoi, A Pannu
Background: Though cryptococcal meningitis (CM) is recognized as a disease of the immunocompromised, studies have implicated that it also affect immunocompetent patients. Methodology: This was a cross sectional study conducted in the Department of Medicine of a tertiary teaching institution in North India. All the patients diagnosed with CM on the basis of detection of cryptococcal antigen or the presence of capsulated budding yeast cells on India ink preparation, from April 2009 to March2015 were included in the study...
October 2017: Journal of the Association of Physicians of India
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