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Cryptococcal meningitis

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 2016: Journal of the Association of Physicians of India
Antonio Carlos Bandeira, José Magalhães Filho, Karine de Almeida Ramos
We describe a 32-yr old woman with AIDS and cryptococcal meningitis that developed cardiomyopathy after 17 days of treatment with Deoxycholate Amphotericin-B (D-Amb) with reversal of the symptoms and transthoracic echocardiogram (TTE) findings after the drug had been stopped and switched to Fluconazole.
September 2016: Medical Mycology Case Reports
Souleymane Sawadogo, Boniface Makumbi, Anne Purfield, Christophine Ndjavera, Gram Mutandi, Andrew Maher, Francina Kaindjee-Tjituka, Jonathan E Kaplan, Benjamin J Park, David W Lowrance
BACKGROUND: Cryptococcal meningitis is common and associated with high mortality among HIV infected persons. The World Health Organization recommends that routine Cryptococcal antigen (CrAg) screening in ART-naïve adults with a CD4+ count <100 cells/μL followed by pre-emptive antifungal therapy for CrAg-positive patients be considered where CrAg prevalence is ≥3%. The prevalence of CrAg among HIV adults in Namibia is unknown. We estimated CrAg prevalence among HIV-infected adults receiving care in Namibia for the purpose of informing routine screening strategies...
2016: PloS One
Aniruddha More, Ravindra Kumar Garg, Hardeep Singh Malhotra, Neeraj Kumar, Ravi Uniyal
BACKGROUND: Acute vision loss in the post-partum period can occur due to many reasons. Eclampsia, posterior reversible encephalopathy syndrome (PRES), pituitary apoplexy, and central serous retinopathy are some of the important causes. Cryptococcal meningitis as a cause of acute vision loss in the post-partum period has not been mentioned in literature. CASE PRESENTATION: A 25-year-old female presented to us with acute bilateral complete vision loss in the post-partum period...
October 19, 2016: BMC Infectious Diseases
Mohammed Rigi, Khurrum Khan, Stacy V Smith, Ayman O Suleiman, Andrew G Lee
Cryptococcal meningitis (CM) is the most common and severe form of cryptococcal infection. In addition to infiltrative and inflammatory mechanisms, intracranial hypertension commonly complicates CM and may cause significant visual and neurological morbidity and mortality. The mainstays of treatment for CM include standard antifungal therapy, management of intracranial hypertension, and treatment of underlying immunosuppressive conditions. Early and aggressive management of intracranial hypertension in accordance with established guidelines reduces the risk of long term visual and neurological complications and death...
October 14, 2016: Survey of Ophthalmology
S Marques, R Carmo, I Ferreira, M Bustorff, S Sampaio, M Pestana
BACKGROUND: In solid organ transplant patients, 8% of invasive fungal infections are attributed to Cryptococcus. The aim of this study was to determine the frequency, risk factors, clinical characteristics, and outcome of kidney transplant recipients (TR) infected with Cryptococcus. CASE SERIES: Between 2007 and 2014, a total of 500 kidney transplantations were performed at São João Hospital, in Porto, Portugal. Six infections by C. neoformans were reported, an incidence of 1...
September 2016: Transplantation Proceedings
John T Kevin, N Iqbal, G Sanjoy
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Sphoorti P Pai, Nagaraja Bs
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Nitin Naik
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Zhiliang Hu, Yongfeng Yang, Jian Cheng, Cong Cheng, Yun Chi, Hongxia Wei
Cryptococcal meningitis (CM) is a common opportunistic infection with a high mortality rate in human immunodeficiency virus (HIV)-infected patients. It is unclear whether mannitol could be used to manage neurological symptoms in HIV-associated CM. Here, we retrospectively analyzed the clinical data of 33 patients with HIV-associated symptomatic CM at our hospital where mannitol was used to relieve neurologic symptoms. With the empirical mannitol therapy, patients had a median of 2 episodes (range, 1-6 episodes) of headaches the day at the starting of anti-cryptococcal therapy...
October 11, 2016: Drug Discoveries & Therapeutics
José E Vidal, Carolina Toniolo, Adriana Paulino, Arnaldo Colombo, Marilena Dos Anjos Martins, Cristina da Silva Meira, Vera Lucia Pereira-Chioccola, Claudia Figueiredo-Mello, Tiago Barros, Jequelie Duarte, Fernanda Fonseca, Mirella Alves, Clara Mendes, Taiana Ribero, Marcia Dos Santos Lazera, Radha Rajasingham, David R Boulware
OBJECTIVE: To determine the prevalence of asymptomatic cryptococcal antigen (CRAG) using lateral flow assay (LFA) in hospitalized HIV-infected patients with CD4 counts < 200 cells/μL. METHODS: Hospitalized HIV-infected patients were prospectively recruited at Instituto de Infectologia Emilio Ribas, a tertiary referral hospital to HIV-infected patients serving the São Paulo State, Brazil. All patients were >18 years old without prior cryptococcal meningitis, without clinical suspicion of cryptococcal meningitis, regardless of antiretroviral (ART)-status, and with CD4 counts <200 cells/μL...
October 3, 2016: Tropical Medicine & International Health: TM & IH
Josephine Mbuagbaw, Ahmadou M Jingi, Jean Jacques N Noubiap, Arnaud D Kaze, Jobert Richie N Nansseu, Jean Joel R Bigna, Edvine Wawo Yonta, Kathleen Ngu Blackett
OBJECTIVE: To describe the trends in mortality and the spectrum of disease in HIV-infected and -uninfected inpatients in a population in Yaoundé. DESIGN: A retrospective study. SETTING: Internal Medicine Unit, University Hospital Centre, Yaoundé, Cameroon. PARTICIPANTS: All deaths registered between January 2000 and May 2007 in the unit. MAIN OUTCOMES MEASURES: Sociodemographic characteristics, clinical features and results of all investigations done, cause of death...
September 2016: JRSM Open
Erika Britz, Olga Perovic, Claire von Mollendorf, Anne von Gottberg, Samantha Iyaloo, Vanessa Quan, Verushka Chetty, Charlotte Sriruttan, Nazir A Ismail, Ananta Nanoo, Alfred Musekiwa, Carl Reddy, Karien Viljoen, Cheryl Cohen, Nelesh P Govender
INTRODUCTION: Meningitis is a major cause of mortality in southern Africa. We aimed to describe the aetiologies and frequencies of laboratory-confirmed fungal and bacterial meningitis among adults in a South African province with an 11% HIV prevalence, over 4 years. METHODS: We conducted a retrospective, observational study of secondary laboratory data, extracted on all cerebrospinal fluid (CSF) specimens submitted to public-sector laboratories in Gauteng province from 2009 through 2012...
2016: PloS One
Kirsten Nielsen, Priya Vedula, Kyle D Smith, David B Meya, Edward P Garvey, William J Hoekstra, Robert J Schotzinger, David R Boulware
Although antifungal drug resistance in the human fungal pathogen Cryptococcus neoformans is relatively uncommon, fluconazole-resistant strains are problematic for preemptive treatment of cryptococcal antigenemia or during cryptococcal meningitis consolidation therapy. We analyzed activity of the experimental antifungal VT-1129 on 51 clinical Cryptococcus neoformans isolates previously screened for fluconazole resistance; with an emphasis on fluconazole dose-dependent (MIC 16-32 μg/ml) or resistant (MIC ≥ 64 μg/ml) isolates...
September 24, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Matobogolo M Boaz, Samuel Kalluvya, Jennifer A Downs, Bonaventura C T Mpondo, Stephen E Mshana
Background. Limited information exists on the etiologies, clinical characteristics, and outcomes of meningitis among HIV-infected patients in Africa. We conducted a study to determine the etiology, clinical characteristics, and outcomes of meningitis among HIV-infected adults. Methods. A prospective cross-sectional hospital based study was conducted among HIV-infected patients aged ≥18 years admitted to the medical wards with symptoms and signs of meningitis. Sociodemographic and clinical information were collected using a standardized data collection tool...
2016: Journal of Tropical Medicine
Melanie D Ward, David E Jones, Myla D Goldman
Fingolimod (Gilenya, Novartis) is an oral sphingosine-1-phosphate analogue used in the treatment of relapsing multiple sclerosis (MS). Fingolimod treatment is associated with relative lymphopenia and was associated with an increased risk of herpes infection in clinical trials. In the post-marketing setting, fingolimod has been associated with several cases of cryptococcal meningitis, recently prompting an update to its prescribing information. To date, all cases have been associated with active treatment with fingolimod...
September 2016: Multiple Sclerosis and related Disorders
Leah T Le, Serena S Spudich
Since the advent of combination antiretroviral therapy (cART), HIV has transformed from a fatal disease to a chronic illness that often presents with milder central nervous system (CNS) symptoms laced with related confounders. The immune recovery associated with access to cART has led to a new spectrum of immune-mediated presentations of infection, phenotypically distinct from the conditions observed in advanced disease.HIV-associated neurocognitive disorder (HAND) entails a categorized continuum of disorders reflecting an array of clinical presentation, outcome, and increasing level of severity: asymptomatic neurocognitive impairment (ANI), mild neurocognitive disorder (MND), and HIV-associated dementia (HAD)...
August 2016: Seminars in Neurology
Tinashe Kenny Nyazika, Ferry Hagen, Tendai Machiridza, Melody Kutepa, Faith Masanganise, Marijke Hendrickx, Teun Boekhout, Tricia Magombei-Majinjiwa, Nonthokozo Siziba, Nyasha Chin'ombe, Kudzanai Mateveke, Jacques Meis, Valerie Jean Robertson
HIV and cryptococcal meningitis coinfection are a major public health problem in most developing countries. Cryptococcus neoformans sensu stricto is responsible for the majority of HIV-associated cryptococcosis cases in sub-Saharan Africa. Despite the available information, little is known about cryptococcal population diversity and its association with clinical outcomes in patients with HIV-associated cryptococcal meningitis in sub-Saharan Africa. In a prospective cohort we investigated the prevalence and clinical outcome of C...
September 13, 2016: Journal of Medical Microbiology
Sara Gago, Carmen Serrano, Ana Alastruey-Izquierdo, Isabel Cuesta, Estrella Martín-Mazuelos, Ana Isabel Aller, Alicia Gómez-López, Emilia Mellado
Cryptococcal meningitis is one of the leading causes of death in HIV/AIDS patients. Our aim was to in order to characterise the epidemiology, antifungal susceptibility pattern and virulence of 28 Cyptococcus sp. strains recovered from 12 AIDS patients during two years in a Spanish single institution. Antifungal susceptibility testing was performed according to the CLSI protocols. Clinical strains were molecularly characterised by serotyping, mating type, PCR fingerprinting (M13 and GACA4 microsatellites) and analysis of two rDNA regions (IGS1 and ITS)...
September 15, 2016: Mycoses
Ya Liu, Mei Kang, Si-Ying Wu, Ying Ma, Zhi-Xing Chen, Yi Xie, Jiang-Tao Tang
Cryptococcus is the major pathogen that causes fungal meningitis. In the People's Republic of China, especially in the Southwest area, cryptococcal meningitis (CM) in HIV-uninfected patients is more common than in HIV-infected patients. We compared clinical features and laboratory data pertaining to CM in patients with different immunological statuses. Demographic data, clinical manifestations, and laboratory data from inpatients in West China Hospital Sichuan University were collected from June 2009 to June 2014...
September 8, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
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