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Cryptococcal meningitis

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https://www.readbyqxmd.com/read/28820702/predictive-model-for-permanent-shunting-in-cryptococcal-meningitis
#1
Woralux Phusoongnern, Siriluck Anunnatsiri, Kittisak Sawanyawisuth, Amnat Kitkhuandee
Cryptococcal meningitis may have long-term morbidity and requires a permanent cerebrospinal fluid shunt. This study aimed to evaluate the risk factors and create a predictive model for permanent shunt treatment in cryptococcal meningitis patients. This was a retrospective analytical study conducted at Khon Kaen University. The study period was from January 2005 to December 2015. We enrolled all adult patients diagnosed with cryptococcal meningitis. Risk factors predictive for permanent shunting treatment were analyzed by multivariate logistic regression analysis...
August 14, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28815430/clinical-evaluation-of-the-antifungal-effect-of-sertraline-in-the-treatment-of-cryptococcal-meningitis-in-hiv-patients-a-single-mexican-center-experience
#2
Hiram Villanueva-Lozano, Rogelio de J Treviño-Rangel, Gloria M González, Pedro A Hernández-Rodríguez, Adrián Camacho-Ortiz, Luis Castillo-Reyna, Sandra G Galindo-Alvarado, Michel F Martínez-Reséndez
PURPOSE: Cryptococcal meningitis is a potentially fatal fungal infection associated with a significant attributable morbidity and mortality, especially among HIV/AIDS patients. The first-line therapy for the treatment of this clinical entity is the combinatory therapy of amphotericin B plus flucytosine. However, the high cost, toxic effects, and limited repertoire of effective antifungal drugs have led to the investigation of novel molecules. This is a prospective, double-blinded, and randomized study performed in a Mexican tertiary care center to evaluate the antifungal activity of sertraline in the treatment of cryptococcal meningitis in HIV patients...
August 16, 2017: Infection
https://www.readbyqxmd.com/read/28807740/outcomes-of-hiv-positive-patients-with-cryptococcal-meningitis-in-the-americas
#3
B Crabtree Ramírez, Y Caro Vega, B E Shepherd, C Le, M Turner, C Frola, B Grinsztejn, C Cortes, D Padgett, T R Sterling, C C McGowan, A Person
BACKGROUND: Cryptococcal meningitis (CM) is associated with substantial mortality in HIV-infected patients. Optimal timing of antiretroviral therapy (ART) in persons with CM represents a clinical challenge, and the burden of CM in Latin America has not been well described. Studies suggest that early ART initiation is associated with higher mortality, but data from the Americas are scarce. METHODS: HIV-infected adults in care between 1985-2014 at participating sites in the Latin America (the Caribbean, Central and South America network (CCASAnet)) and the Vanderbilt Comprehensive Care Clinic (VCCC) and who had CM were included...
August 11, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28806629/aseptic-meningitis-in-adults-and-children-diagnostic-and-management-challenges
#4
Bhavarth Shukla, Elizabeth A Aguilera, Lucrecia Salazar, Susan H Wootton, Quanhathai Kaewpoowat, Rodrigo Hasbun
BACKGROUND: Aseptic meningitis represents a common diagnostic and management dilemma to clinicians. OBJECTIVES: To compare the clinical epidemiology, diagnostic evaluations, management, and outcomes between adults and children with aseptic meningitis. STUDY DESIGN: We conducted a retrospective study from January 2005 through September 2010 at 9 Memorial Hermann Hospitals in Houston, TX. Patients age≥2months who presented with community-acquired aseptic meningitis with a CSF white blood cell count >5cells/mm(3) and a negative Gram stain and cultures were enrolled...
August 4, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28799299/a-comparative-study-of-csf-viral-rna-loads-between-hiv-positive-patients-with-neurological-manifestations-and-neurologically-asymptomatic-hiv-patients
#5
A D Mathur, S Devesh
INTRODUCTION: There are conflicting reports in literature about correlation of CSF viral RNA levels with neurological manifestations in HIV positive patients. Many studies in animals and human subjects have shown that CSF HIV-1 RNA can be useful as a specific marker of HIV induced neuropathology. To the contrary there are studies which show that neurological disease states can occur in absence of significant increase of CSF HIV RNA. MATERIALS AND METHODS: This was a prospective study conducted at Base hospital Delhi Cantt, New Delhi, a tertiary care hospitals for HIV patients...
August 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28793057/noninvasive-intracranial-pressure-monitoring-for-hiv-associated-cryptococcal-meningitis
#6
V R Bollela, G Frigieri, F C Vilar, D L Spavieri, F J Tallarico, G M Tallarico, R A P Andrade, T M de Haes, O M Takayanagui, A M Catai, S Mascarenhas
Mortality and adverse neurologic sequelae from HIV-associated cryptococcal meningitis (HIV-CM) remains high due to raised intracranial pressure (ICP) complications. Cerebrospinal fluid (CSF) high opening pressure occurs in more than 50% of HIV-CM patients. Repeated lumbar puncture with CSF drainage and external lumbar drainage might be required in the management of these patients. Usually, there is a high grade of uncertainty and the basis for clinical decisions regarding ICP hypertension tends to be from clinical findings (headache, nausea and vomiting), a low Glasgow coma scale score, and/or fundoscopic papilledema...
August 7, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28793019/cryptococcus-neoformans-and-c-gattii-isolates-from-both-hiv-infected-and-uninfected-patients-antifungal-susceptibility-and-outcome-of-cryptococcal-disease
#7
Erika Nascimento, Lucia Helena Vitali, Marcia Regina von Zeska Kress, Roberto Martinez
One of the factors causing treatment failure in cryptococcosis is the resistance of Cryptococcus spp. to antifungal drugs, which has motivated the susceptibility assessment of isolates from patients with cryptococcosis, different clinical conditions and infections outcomes. Clinical isolates of Cryptococcus spp. from three different groups of patients were studied in the present investigation: 19 HIV-positive patients with relapsing and/or refractory meningitis (Group 1), 30 HIV-positive patients who experienced a single and limited episode of cryptococcosis (Group 2), and 19 HIV-negative patients with cryptococcosis (Group 3)...
2017: Revista do Instituto de Medicina Tropical de São Paulo
https://www.readbyqxmd.com/read/28790866/incidence-clinical-presentation-and-outcome-of-hiv-1-associated-cryptococcal-meningitis-during-the-highly-active-antiretroviral-therapy-era-a-nationwide-cohort-study
#8
Madeleine Touma, Line D Rasmussen, Raquel Martin-Iguacel, Frederik Neess Engsig, Nina Breinholt Stærke, Mette Stærkind, Niels Obel, Magnus Glindvad Ahlström
BACKGROUND: Human immunodeficiency virus (HIV) infection with advanced immunosuppression predisposes to cryptococcal meningitis (CM). We describe the incidence, clinical presentation, and outcome of CM in HIV-infected individuals during the highly active antiretroviral therapy (HAART) era. METHODS: A nationwide, population-based cohort of HIV-infected individuals was used to estimate incidence and mortality of CM including risk factors. A description of neurological symptoms of CM at presentation and follow-up in the study period 1995-2014 was included in this study...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28783390/cryptococcal-meningitis
#9
Damien K Ming, Thomas S Harrison
No abstract text is available yet for this article.
August 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28775082/disseminated-cryptococcal-infection-in-a-patient-who-had-kidney-transplant-discrepancy-between-clinical-symptoms-and-microbiological-findings
#10
Suzan Dahdal, Robert Kalicki, Niklaus Von Steiger, Parham Sendi
A 29-year-old man complained of a 2-day history of frontal headache and new-onset fever but no other symptoms. Two months prior to admission, he underwent his third kidney transplantation. Clinical and laboratory examinations were unremarkable. Brain MRI showed a meningeal irritation consistent with viral meningitis. A diagnosis of cryptococcal meningitis and fungaemia was made after detection of a remarkably high and visible load of Cryptococcus neoformans in the cerebrospinal fluid.
August 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28774293/the-clinical-utility-of-the-urine-based-lateral-flow-lipoarabinomannan-assay-in-hiv-infected-adults-in-myanmar-an-observational-study
#11
Swe Swe Thit, Ne Myo Aung, Zaw Win Htet, Mark A Boyd, Htin Aung Saw, Nicholas M Anstey, Tint Tint Kyi, David A Cooper, Mar Mar Kyi, Josh Hanson
BACKGROUND: The use of the point-of-care lateral flow lipoarabinomannan (LF-LAM) test may expedite tuberculosis (TB) diagnosis in HIV-positive patients. However, the test's clinical utility is poorly defined outside sub-Saharan Africa. METHODS: The study enrolled consecutive HIV-positive adults at a tertiary referral hospital in Yangon, Myanmar. On enrolment, patients had a LF-LAM test performed according to the manufacturer's instructions. Clinicians managing the patients were unaware of the LF-LAM result, which was correlated with the patient's clinical course over the ensuing 6 months...
August 4, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28752102/acute-kidney-injury-and-urinary-biomarkers-in-human-immunodeficiency-virus-associated-cryptococcal-meningitis
#12
Charlotte Schutz, David R Boulware, Katherine Huppler-Hullsiek, Maximilian von Hohenberg, Joshua Rhein, Kabanda Taseera, Friedrich Thienemann, Conrad Muzoora, David B Meya, Graeme Meintjes
BACKGROUND: Cryptococcus is the most common etiology of adult meningitis in Africa. Amphotericin B deoxycholate remains paramount to treatment, despite toxicities, including acute kidney injury (AKI). We assessed the ability of the following urine markers to predict AKI in patients who received amphotericin B: urine neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (CysC), tissue inhibitor of metalloproteinases-2 (TIMP-2), and protein. METHODS: One hundred and thirty human immunodeficiency virus (HIV)-infected participants with cryptococcal meningitis were enrolled and received amphotericin and fluconazole for 2 weeks...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28750078/acridine-orange-fluorescent-microscopy-is-more-sensitive-than-india-ink-light-microscopy-in-the-rapid-detection-of-cryptococcosis-among-crag-positive-hiv-patients
#13
Richard Kwizera, Andrew Akampurira, Darlisha Williams, David R Boulware, David B Meya
BACKGROUND: India ink microscopy on cerebrospinal fluid is still utilized in resource limited settings for the diagnosis of cryptococcal meningitis despite its poor sensitivity. We hypothesized that staining fungal nucleic acids with fluorescent dyes instead of the capsule with India ink might improve sensitivity for the diagnosis of cryptococcal meningitis. METHODS: We enrolled 96 HIV-infected participants with cryptococcal meningitis who provided 194 CSF specimens at serial time points in Kampala, Uganda...
2017: PloS One
https://www.readbyqxmd.com/read/28736880/central-nervous-system-infection-due-to-cryptococcus-gattii-sensu-lato-in-india-analysis-of-clinical-features-molecular-profile-and-antifungal-susceptibility
#14
Shayanki Lahiri Mukhopadhyay, Veenakumari H Bahubali, Netravathi Manjunath, Aarthi Swaminathan, Sayani Maji, Marimuthu Palaniappan, Satishchandra Parthasarathy, Nagarathna Chandrashekar
Cryptococcus gattii species complex has evolved as a pathogen in the last two decades causing infection among both immunocompetent and immunocompromised hosts. We aimed to analyse the clinical features of CNS infection caused by C. gattii sensu lato, molecular and antifungal susceptibility profile of this pathogen. Cases diagnosed to have CNS cryptococcosis were included in the study. Cryptococcus recovered from patient's specimen was identified by standard protocol. Species confirmation, mating type and molecular type determination were performed by PCR based methods...
July 23, 2017: Mycoses
https://www.readbyqxmd.com/read/28700464/cryptococcal-meningitis-after-transnasal-transsphenoidal-pituitary-microsurgery-of-acth-secreting-pituitary-adenoma-a-case-report
#15
Yang Liu, Ming Feng, Yong Yao, Kan Deng, Xinjie Bao, Xiaohai Liu, Renzhi Wang
RATIONALE: Microbial infection should be regarded in the differential diagnosis of neurosurgical complications after transnasal transsphenoidal pituitary microsurgery, albeit cryptococcal meningitis is rare. This article will discuss the risk factors of cryptococcal meningitis in patients underwent transnasal transsphenoidal pituitary microsurgery, and summary the potential origins of infection. PATIENT CONCERNS AND DIAGNOSIS: Here, we report a case of 37-year-old male who had cryptococcal meningitis after transnasal transsphenoidal pituitary microsurgery of a relapsing ACTH-secreting pituitary adenoma...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28693927/risk-factors-and-outcomes-of-cerebrospinal-fluid-overdrainage-in-hiv-negative-patients-with-cryptococcal-meningitis-after-the-ventriculoperitoneal-shunting-procedure
#16
Chih-Wei Hung, Wei-Che Lin, Wen-Neng Chang, Tsung-Ming Su, Chia-Te Kung, Nai-Wen Tsai, Hung-Chen Wang, Chih-Cheng Huang, Ben-Chung Cheng, Yu-Jih Su, Ya-Ting Chang, Chih-Min Su, Sheng-Yuan Hsiao, Cheng-Hsien Lu
PURPOSE: Shunt procedures used to treat cryptococcal meningitis complicated with hydrocephalus and/or increased intracranial pressure (IICP) could result in cerebrospinal fluid (CSF) overdrainage, thereby presenting therapeutic challenges. METHODS: We analyzed the clinical features and neuroimaging findings after the ventriculoperitoneal (VP) shunt procedure in 51 HIV (Human Immunodeficiency Virus)-negative patients with cryptococcal meningitis, to assess the risk factors associated with post-shunt CSF overdrainage...
June 28, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28687690/cryptococcal-meningitis-causing-obstructive-hydrocephalus-in-a-patient-on-fingolimod
#17
Chengde Pham, Iwan Bennett, Rondhir Jithoo
Cryptococcosis is a recognised opportunistic infection in immunocompromised patients. The long-term adverse effect profile of fingolimod, an immunomodulating agent approved for use in multiple sclerosis in 2010, is only just emerging. We report the first case to our knowledge of a patient presenting with obstructive hydrocephalus secondary to cryptococcal meningitis in the setting of fingolimod therapy. Extensive posterior fossa leptomeningeal inflammation with associated cerebellar oedema resulted in effacement of the fourth ventricle and obstructive hydrocephalus requiring urgent ventriculostomy...
July 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28679543/tracing-genetic-exchange-and-biogeography-of-cryptococcus-neoformans-var-grubii-at-the-global-population-level
#18
Johanna Rhodes, Christopher A Desjardins, Sean M Sykes, Mathew A Beale, Mathieu Vanhove, Sharadha Sakthikumar, Yuan Chen, Sharvari Gujja, Sakina Saif, Anuradha Chowdhary, Daniel John Lawson, Vinicius Ponzio, Arnaldo Lopes Colombo, Wieland Meyer, David M Engelthaler, Ferry Hagen, Maria Teresa Illnait-Zaragozi, Alexandre Alanio, Jo-Marie Vreulink, Joseph Heitman, John R Perfect, Anastasia Litvintseva, Tihana Bicanic, Thomas S Harrison, Matthew C Fisher, Christina A Cuomo
Cryptococcus neoformans var. grubii is the causative agent of cryptococcal meningitis, a significant source of mortality in immunocompromised individuals, typically HIV/AIDS patients from developing countries. Despite the worldwide emergence of this ubiquitous infection, little is known about the global molecular epidemiology of this fungal pathogen. Here we sequence the genomes of 188 diverse isolates and characterized the major subdivisions, their relative diversity and the level of genetic exchange between them...
July 5, 2017: Genetics
https://www.readbyqxmd.com/read/28673256/cryptococcosis-in-patients-with-hematological-diseases-a-14-year-retrospective-clinical-analysis-in-a-chinese-tertiary-hospital
#19
Rui-Ying Wang, Yan-Qiong Chen, Ji-Qin Wu, Xuan Wang, Ya-Hui Cao, Hua-Zhen Zhao, Li-Ping Zhu
BACKGROUND: Cryptococcal infection has become a public health challenge globally. However, information about cryptococcal infection in patients with hematological diseases remains relatively rare. METHODS: HIV-uninfected cryptococcosis cases with hematological diseases admitted to Huashan Hospital from January 2001 to December 2014 were reviewed. RESULTS: In total, 33 cryptococcosis patients were enrolled, including 12 malignant and 21 non-malignant hematological cases...
July 3, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28662028/cryptococcal-meningitis-a-neglected-ntd
#20
Síle F Molloy, Tom Chiller, Gregory S Greene, Jessica Burry, Nelesh P Govender, Cecilia Kanyama, Sayoki Mfinanga, Sokoine Lesikari, Yacouba N Mapoure, Charles Kouanfack, Victor Sini, Elvis Temfack, David R Boulware, Francoise Dromer, David W Denning, Jeremy Day, Neil R H Stone, Tihana Bicanic, Joseph N Jarvis, Olivier Lortholary, Thomas S Harrison, Shabbar Jaffar, Angela Loyse
No abstract text is available yet for this article.
June 2017: PLoS Neglected Tropical Diseases
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