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Cryptococcal meningitis

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https://www.readbyqxmd.com/read/28527158/asymptomatic-cryptococcal-antigenemia-in-people-living-with-hiv-plhiv-with-severe-immunosuppression-is-routine-crag-screening-indicated-in-india
#1
S Anuradha, Abhaya Narayana H, Richa Dewan, Ravinder Kaur, K Rajeshwari
BACKGROUND: Cryptococcal meningitis (CM) is a common, life-threatening opportunistic infection (OI) among people living with HIV (PLHIV) in India. Serum Cryptococcal antigen (CrAg) positivity is predictive of future occurrence of CM and pre-emptive treatment reduces its mortality. Routine CrAg screening among PLHIV is not adopted by India's national programme. This study evaluated the prevalence of CrAg and assessed CrAg positivity in predicting all-cause mortality among PLHIV. METHODS: This prospective study was conducted in a tertiary care, public health facility in New Delhi, India...
April 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28505328/advanced-hiv-disease-in-botswana-following-successful-antiretroviral-therapy-rollout-incidence-of-and-temporal-trends-in-cryptococcal-meningitis
#2
Mark W Tenforde, Margaret Mokomane, Tshepo Leeme, Raju K K Patel, Nametso Lekwape, Chandapiwa Ramodimoosi, Bonno Dube, Elizabeth A Williams, Kelebeletse O Mokobela, Ephraim Tawanana, Tlhagiso Pilatwe, William J Hurt, Hannah Mitchell, Doreen L Banda, Hunter Stone, Mooketsi Molefi, Kabelo Mokgacha, Heston Phillips, Paul C Mullan, Andrew P Steenhoff, Yohana Mashalla, Madisa Mine, Joseph N Jarvis
Background: Botswana has a well-developed antiretroviral therapy (ART) program which serves as a regional model. With wide ART availability, the burden of advanced HIV and associated opportunistic infections would be expected to decline. We performed a nationwide surveillance study to determine the national incidence of cryptococcal meningitis, and describe characteristics of cases 2000-2014 and temporal trends at two national referral hospitals. Methods: Cerebrospinal fluid data from all 37 laboratories performing meningitis diagnostics in Botswana were collected 2000-2014 to identify cases of cryptococcal meningitis...
May 13, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28502948/disseminated-cryptococcosis-with-adrenal-insufficiency-and-meningitis-in-an-immunocompetent-individual
#3
Misa Ito, Takashi Hinata, Kaku Tamura, Ayano Koga, Toshimitsu Ito, Hiroko Fujii, Fumihiko Hirata, Hidenari Sakuta
We present a case of cryptococcosis with adrenal insufficiency and meningitis in a healthy host without any risk factors. Antifungal therapy did not reduce the cryptococcal antigen titers of the cerebrospinal fluid and serum or the bilateral adrenal gland enlargement. It was suggested that the adrenal glands were the focus of persistent fungemia. Removal of both adrenal glands brought about a response to antifungal therapy. We conclude that if antifungal therapy is ineffective, bilateral adrenalectomy is an effective measure for treatment of such patients...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28486489/cytokine-patterns-in-a-prospective-cohort-of-hiv-infected-patients-with-cryptococcal-meningitis-following-initiation-of-antifungal-and-antiretroviral-therapy
#4
Delio José Mora, Kennio Ferreira-Paim, Leonardo Eurípedes Andrade-Silva, Thatiane Bragine, Ivonete Helena Rocha, Barbara de Melo Ribeiro, Guilherme Henrique Machado, Virmondes Rodrigues Junior, David Nascimento Silva-Teixeira, Wieland Meyer, Mario León Silva-Vergara
Cryptococcal meningitis (CM) is a life-threatening infection in HIV-infected patients, especially in resource-limited settings. Cytokine patterns in the cerebrospinal fluid (CSF) and sera may be related to clinical outcomes. This study aimed to evaluate cytokine patterns in the CSF and sera of HIV-infected patients with CM as well as the cytokines produced by peripheral blood mononuclear cells (PBMCs) when stimulated with LPS and cryptococcal GXM. CSF and serum levels of IL-2, IL-4, IL-8, IL-10, IL-12p40, IL-17A, INF-γ, TNF-α and CXCL-10 were measured in HIV-infected patients with CM (CM+ HIV+) at various time points...
2017: PloS One
https://www.readbyqxmd.com/read/28483963/influence-of-experimental-cryptococcal-meningitis-in-wistar-rats-on-voriconazole-brain-penetration-assessed-by-microdialysis
#5
Izabel Almeida Alves, Keli Jaqueline Staudt, Carolina de Miranda Silva, Graziela de Araujo Lock, Teresa Dalla Costa, Bibiana Verlindo de Araujo
To advance in the treatment of cryptococcal meningites is crucial to know the drug's free fraction that reaches the biophase. In the present study we applied the microdialysis (μD) as a tool to determine the free levels reached by voriconazole (VRC) in the brain of healthy and Cryptococcus neoformans infected rats. The infection was induced by the i.v. administration of 1⋅10(5) CFU of yeast. The dose administered was 5 mg/kg i.v. of VRC. Plasma and microdialysate samples were analyzed by LC-MS/MS and LC-UV methods...
May 8, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28483416/the-relentless-march-of-cryptococcal-meningitis
#6
Peter R Williamson
No abstract text is available yet for this article.
May 5, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28483415/global-burden-of-disease-of-hiv-associated-cryptococcal-meningitis-an-updated-analysis
#7
Radha Rajasingham, Rachel M Smith, Benjamin J Park, Joseph N Jarvis, Nelesh P Govender, Tom M Chiller, David W Denning, Angela Loyse, David R Boulware
BACKGROUND: Cryptococcus is the most common cause of meningitis in adults living with HIV in sub-Saharan Africa. Global burden estimates are crucial to guide prevention strategies and to determine treatment needs, and we aimed to provide an updated estimate of global incidence of HIV-associated cryptococcal disease. METHODS: We used 2014 Joint UN Programme on HIV and AIDS estimates of adults (aged >15 years) with HIV and antiretroviral therapy (ART) coverage...
May 5, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28480277/epidemiology-of-cryptococcosis-and-cryptococcal-meningitis-in-a-large-retrospective-cohort-of-patients-after-solid-organ-transplantation
#8
Ige A George, Carlos A Q Santos, Margaret A Olsen, William G Powderly
BACKGROUND: Cryptococcosis is the third most common invasive fungal infection in solid organ transplant (SOT) recipients. There are no nationally representative data describing the incidence, risk factors, and outcomes of cryptococcosis after SOT. METHODS: We assembled a large cohort of adult SOT recipients using Classification of Diseases, Ninth Revision, Clinical Modification billing data from Healthcare Cost and Utilization Project State Inpatient Databases of Florida (2006-2012), New York (2006-2011), and California (2004-2010)...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28470016/relationship-of-human-immunodeficiency-virus-viral-load-in-cerebrospinal-fluid-and-plasma-in-patients-co-infected-with-cryptococcal-meningitis
#9
Christina C Chang, Richard Kangethe, Saleha Omarjee, Keshni Hiramen, Bernadett Gosnell, Katlego Sojane, Mohamed-Yunus S Moosa, Sharon R Lewin, Martyn A French, Thumbi Ndung'u
We measured human immunodeficiency virus (HIV) ribonucleic acid (RNA) in paired cerebrospinal fluid (CSF) and plasma samples in a prospective study of 91 HIV-infected, antiretroviral therapy-naive patients with cryptococcal meningitis. Cerebrospinal fluid HIV RNA was lower than in plasma (median 4.7 vs 5.2 log10 copies/mL, P < .0001) and positively correlated with plasma HIV RNA, peripheral CD4(+) T-cell percentage, and CSF CXCL10. Plasma/CSF ratio of HIV RNA ranged widely from 0.2 to 265.5 with a median of 2...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28469695/molecular-diagnosis-of-central-nervous-system-opportunistic-infections-and-mortality-in-hiv-infected-adults-in-central-china
#10
Rongrong Yang, Hong Zhang, Yong Xiong, Xien Gui, Yongxi Zhang, Liping Deng, Shicheng Gao, Mingqi Luo, Wei Hou, Deyin Guo
BACKGROUND: CSF PCR is the standard diagnostic technique used in resource-rich settings to detect pathogens of the CNS infection. However, it is not currently used for routine CSF testing in China. Knowledge of CNS opportunistic infections among people living with HIV in China is limited. METHODS: Intensive cerebrospiral fluid (CSF) testing was performed to evaluate for bacterial, viral and fungal etiologies. Pathogen-specific primers were used to detect DNA from cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6) and John Cunningham virus (JCV) via real-time polymerase chain reaction (PCR)...
2017: AIDS Research and Therapy
https://www.readbyqxmd.com/read/28464834/molecular-diagnosis-of-central-nervous-system-opportunistic-infections-and-mortality-in-hiv-infected-adults-in-central-china
#11
Rongrong Yang, Hong Zhang, Yong Xiong, Xien Gui, Yongxi Zhang, Liping Deng, Shicheng Gao, Mingqi Luo, Wei Hou, Deyin Guo
BACKGROUND: CSF PCR is the standard diagnostic technique used in resource-rich settings to detect pathogens of the CNS infection. However, it is not currently used for routine CSF testing in China. Knowledge of CNS opportunistic infections among people living with HIV in China is limited. METHODS: Intensive cerebrospiral fluid (CSF) testing was performed to evaluate for bacterial, viral and fungal etiologies. Pathogen-specific primers were used to detect DNA from cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6) and John Cunningham virus (JCV) via real-time polymerase chain reaction (PCR)...
May 2, 2017: AIDS Research and Therapy
https://www.readbyqxmd.com/read/28458934/normalization-of-bilateral-adrenal-gland-enlargement-after-treatment-for-cryptococcosis
#12
Yuka Muraoka, Shintaro Iwama, Hiroshi Arima
Cryptococcosis usually occurs in immunocompromised patients and can cause enlargement of the adrenal glands, although the morphologic changes after treatment have not been reported in detail. We report the case of 24-year-old man with fevers, headaches, and impaired consciousness who had been treated with glucocorticoids for a protein-losing gastroenteropathy. The cerebrospinal fluid analysis revealed cryptococcal meningitis. Computed tomography showed bilateral adrenal enlargement. A retrospective analysis revealed that the enlargement had been detected 5 months before admission and gradually increased...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28446137/progressive-cutaneous-cryptococcosis-complicated-with-meningitis-in-a-myasthenia-gravis-patient-on-long-term-immunosuppressive-therapy-a-case-report
#13
Nguyen Thi Cam Huong, Ahmed M A Altibi, Nguyen My Hoa, Le Anh Tuan, Samar Salman, Sara Morsy, Nguyen Thi Bich Lien, Nguyen Thanh Truong, Nguyen Thi Hoang Mai, Pham Thi Le Hoa, Nguyen Ba Thang, Van The Trung
BACKGROUND: Cryptococcosis is an opportunistic infection caused by the encapsulated yeast Cryptococcus neoformans and most remarkably manifests in HIV-infected individuals, especially in the settings of very low CD4 count. Development of cryptococcosis in HIV-uninfected individuals is exceedingly rare and usually signifies a marked immunodeficiency. Cryptococcosis in association with myasthenia gravis or thymoma has been previously documented in only very few cases in the literature. CASE PRESENTATION: We reported a complicated case of severe cutaneous cryptococcosis in a 39-year-old Vietnamese male patient with myasthenia gravis on long-term immunosuppressive therapy...
April 26, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28421878/cerebrovascular-injury-in-cryptococcal-meningitis
#14
Ajay Kumar Mishra, Vanjare Harshad Arvind, Divya Muliyil, Cijoy K Kuriakose, Anu Anna George, Reka Karuppusami, Ronald Albert Benton Carey, Sunithi Mani, Samuel George Hansdak
Background Cryptococcal meningitis continues to be one of the common causes of chronic central nervous system infection worldwide. Individuals with cryptococcal meningitis can occasionally present with small vessel vasculitis causing infarcts primarily in the basal ganglia, internal capsule, and thalamus. Literature regarding patterns of cerebrovascular injury among patients with cryptococcal meningitis is scanty, and outcome following these vascular involvements is unknown. Aim To study the clinical profile, imaging findings, and details of vascular territory involved among patients admitted with cryptococcal meningitis and central nervous system infarct in a tertiary care center from India...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28384860/fungal-opportunistic-pneumonias-in-hiv-aids-patients-an-indian-tertiary-care-experience
#15
Ravinder Kaur, Bhanu Mehra, Megh Singh Dhakad, Ritu Goyal, Preena Bhalla, Richa Dewan
INTRODUCTION: Opportunistic pneumonias are a major cause of mortality and morbidity in Human Immunodeficiency Virus (HIV) reactive patients. Despite the significant role that fungi play in causation of this opportunistic mycoses, very few Indian studies have attempted to investigate the burden and aetiological spectrum of HIV/AIDS-associated fungal pneumonias. AIM: To document the prevalence of fungal aetiology in HIV/AIDS-related opportunistic pneumonias in an Indian setting; and to elucidate the various fungal opportunists responsible for the same...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28355252/factors-associated-with-early-mycological-clearance-in-hiv-associated-cryptococcal-meningitis
#16
Fátima Concha-Velasco, Elsa González-Lagos, Carlos Seas, Beatriz Bustamante
INTRODUCTION: The first-line combination therapy for HIV-associated cryptococcal meningitis (CM), a condition of high mortality particularly in the first two weeks of treatment, consists of amphotericin B plus flucytosine (5-FC). Given that 5-FC remains unavailable in many countries, the knowledge of factors influencing mycological clearance in patients treated with second-line therapy could contribute to effective management. OBJECTIVES: To determine the factors associated with the clearance of Cryptococcus sp...
2017: PloS One
https://www.readbyqxmd.com/read/28348767/first-case-of-mixed-infection-with-cryptococcus-deuterogattii-and-cryptococcus-neoformans-vni-in-an-ivorian-hiv-positive-patient
#17
Fulgence K Kassi, Virginie Bellet, Adama Doumbia, Donika Krasteva, Pascal Drakulovski, Gisèle A Kouakou, François Gatchitch, Eric Delaporte, Jacques Reynes, Michèle Mallié, Hervé I E Menan, Sébastien Bertout
INTRODUCTION: Cryptococcal meningitis (CM) may be caused by several species of Cryptococcus. CASE PRESENTATION: We describe a fatal case of CM in a HIV-positive patient from Ivory Coast infected by Cryptococcus neoformans VNI and Cryptococcusdeuterogattii. Isolates were recovered from cerebrospinal fluid (CSF) prior to systemic antifungal treatment. Six isolates were studied (the entire culture plus five isolated colonies from it). Serotyping was performed via LAC 1 and CAP 64 gene amplification...
August 2016: JMM Case Reports
https://www.readbyqxmd.com/read/28346317/the-csf-immune-response-in-hiv-1-associated-cryptococcal-meningitis-macrophage-activation-correlates-of-disease-severity-and-effect-of-antiretroviral-therapy
#18
James E Scriven, Lisa M Graham, Charlotte Schutz, Thomas J Scriba, Katalin A Wilkinson, Robert J Wilkinson, David R Boulware, Britta C Urban, Graeme Meintjes, David G Lalloo
BACKGROUND: Immune modulation may improve outcome in HIV-associated cryptococcal meningitis. Animal studies suggest alternatively activated macrophages are detrimental but human studies are limited. We performed a detailed assessment of the cerebrospinal fluid (CSF) immune response and examined immune correlates of disease severity and poor outcome, and the effects of antiretroviral therapy (ART). METHODOLOGY: We enrolled persons ≥18 years with first episode of HIV-associated cryptococcal meningitis...
March 31, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28339414/update-on-the-application-of-optic-nerve-sheath-fenestration
#19
Hui Chen, Qian Zhang, Song Tan, Huazhu Fu, Bradley K Farris, Zhenglin Yang
BACKGROUND: With the ongoing development of surgical procedures and instruments, the safety of optic nerve sheath fenestration (ONSF) has been improved. OBJECTIVE: Through the past three decades, progress has been made in preventing visual loss from chronic optic nerve swelling in idiopathic intracranial hypertension (IIH), secondary intracranial hypertension and local optic nerve diseases. We now review the updated application of ONSF in those diseases. METHODS: The application of ONSF in papilledema due to IIH, secondary intracranial hypertension to cerebral venous sinus occlusion, Cryptococcal meningitis, and intracranial mass or tumors is reviewed...
March 23, 2017: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/28335769/cost-effectiveness-of-crag-lfa-screening-for-cryptococcal-meningitis-among-people-living-with-hiv-in-uganda
#20
Anu Ramachandran, Yukari Manabe, Radha Rajasingham, Maunank Shah
BACKGROUND: Cryptococcal meningitis (CM) constitutes a significant source of mortality in resource-limited regions. Cryptococcal antigen (CRAG) can be detected in the blood before onset of meningitis. We sought to determine the cost-effectiveness of implementing CRAG screening using the recently developed CRAG lateral flow assay in Uganda compared to current practice without screening. METHODS: A decision-analytic model was constructed to compare two strategies for cryptococcal prevention among people living with HIV with CD4 < 100 in Uganda: No cryptococcal screening vs...
March 23, 2017: BMC Infectious Diseases
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