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Cryptococcal meningitis

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https://www.readbyqxmd.com/read/28631642/sporadic-occurrence-of-cryptococcal-meningitis-in-hiv-seronegative-patients-uncommon-etiology
#1
Shukla Das, Shyama Datt, Priyamvada Roy, Rumpa Saha, Immaculata Xess
Cryptococcosis in HIV-seronegative patients is rarely reported from India. This prospective study was conducted to look for cryptococcal meningitis in HIV-seronegative individuals and compare their laboratory features to cryptococcal meningitis in HIV-seropositive patients. Cerebrospinal fluid was collected from 153 suspected cases of meningitis and subjected to India ink preparation, antigen detection, and culture. Nineteen samples tested positive for Cryptococcus neoformans infection. Seventeen and two patients were HIV reactive and nonreactive, respectively...
April 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28630940/fluconazole-induced-ploidy-change-in-cryptococcus-neoformans-results-from-the-uncoupling-of-cell-growth-and-nuclear-division
#2
Sophie Altamirano, Diana Fang, Charles Simmons, Shreyas Sridhar, Peipei Wu, Kaustuv Sanyal, Lukasz Kozubowski
Cryptococcus neoformans is a pathogenic yeast that causes lethal cryptococcal meningitis in immunocompromised patients. One of the challenges in treating cryptococcosis is the development of resistance to azole antifungals. Previous studies linked azole resistance to elevated numbers of copies of critical resistance genes in aneuploid cells. However, how aneuploidy is formed in the presence of azole drugs remains unclear. This study showed that treatment with inhibitory concentrations of an azole drug, fluconazole (FLC), resulted in a significant population of cells with increased DNA content, through the following defects: inhibition of budding, premature mitosis, and inhibition of cytokinesis followed by replication in the mother cell...
May 2017: MSphere
https://www.readbyqxmd.com/read/28617817/prevalence-of-cryptococcal-infection-among-advanced-hiv-patients-in-argentina-using-lateral-flow-immunoassay
#3
Claudia Frola, Liliana Guelfand, Gabriela Blugerman, Edgardo Szyld, Sara Kaufman, Pedro Cahn, Omar Sued, Héctor Pérez
BACKGROUND: Globally, Latin America ranks third among regions with most cases of AIDS related cryptococcal meningitis. In 2009, a lateral flow immunoassay (LFA) for the detection of cryptococcal antigen (CrAg) was developed as a potential point-of-care test for diagnosis of cryptococcal infection. In 2011 World Health Organizations recommended on CrAg screening for HIV positive persons with CD4 below 100 cells/μL, followed by preemptive fluconazole treatment. However, in Argentina no formal recommendations for CrAg screening have been issued...
2017: PloS One
https://www.readbyqxmd.com/read/28614360/comparative-genomics-of-cryptococcus-neoformans-var-grubii-associated-with-meningitis-in-hiv-infected-and-uninfected-patients-in-vietnam
#4
Jeremy N Day, Seet Qihui, Lam Tuan Thanh, Phan Hai Trieu, Anh Duong Van, Nha Hoang Thu, Tran Thi Hong Chau, Nguyen P H Lan, Nguyen Van Vinh Chau, Philip M Ashton, Guy E Thwaites, Maciej F Boni, Marcel Wolbers, Niranjan Nagarajan, Patrick B O Tan, Stephen Baker
The vast burden of cryptococcal meningitis occurs in immunosuppressed patients, driven by HIV, and is caused by Cryptococcus neoformans var. grubii. We previously reported cryptococcal meningitis in Vietnam arising atypically in HIV uninfected, apparently immunocompetent patients, caused by a single amplified fragment length polymorphism (AFLP) cluster of C. neoformans var. grubii (VNIγ). This variant was less common in HIV infected individuals; it remains unclear why this lineage is associated with apparently immunocompetent patients...
June 14, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28606065/neurocognitive-function-in-hiv-infected-persons-with-asymptomatic-cryptococcal-antigenemia-a-comparison-of-three-prospective-cohorts
#5
Martha P Montgomery, Noeline Nakasujja, Bozena M Morawski, Radha Rajasingham, Joshua Rhein, Elizabeth Nalintya, Darlisha A Williams, Kathy Huppler Hullsiek, Agnes Kiragga, Melissa A Rolfes, Renee Donahue Carlson, Nathan C Bahr, Kate E Birkenkamp, Yukari C Manabe, Paul R Bohjanen, Jonathan E Kaplan, Andrew Kambugu, David B Meya, David R Boulware
BACKGROUND: HIV-infected persons with detectable cryptococcal antigen (CrAg) in blood have increased morbidity and mortality compared with HIV-infected persons who are CrAg-negative. This study examined neurocognitive function among persons with asymptomatic cryptococcal antigenemia. METHODS: Participants from three prospective HIV cohorts underwent neurocognitive testing at the time of antiretroviral therapy (ART) initiation. Cohorts included persons with cryptococcal meningitis (N = 90), asymptomatic CrAg + (N = 87), and HIV-infected persons without central nervous system infection (N = 125)...
June 12, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28584681/abdominal-pseudocyst-as-a-complication-of-ventriculoperitoneal-shunt-placement-review-of-the-literature-and-a-proposed-algorithm-for-treatment-using-4-illustrative-cases
#6
Samir Kashyap, Hammad Ghanchi, Tanya Minasian, Fanglong Dong, Dan Miulli
BACKGROUND: Ventriculoperitoneal (VP) shunt placement is one of the most commonly performed procedures in neurosurgery. One rare complication is the formation of an abdominal pseudocyst, which can cause shunt malfunction. CASE DESCRIPTIONS: We present four unique cases of abdominal pseudocyst formation. Our first patient initially presented with a right upper quadrant pseudocyst. Shunt was externalized and the distal end was revised with placement of catheter on the opposite side...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28576330/first-report-of-two-cases-of-cryptococcosis-in-tripoli-libya-infected-with-cryptococcus-neoformans-isolates-present-in-the-urban-area
#7
M S Ellabib, Z A Krema, A A Allafi, M Cogliati
Cryptococcosis is a potentially fatal fungal disease caused by the basidiomycetes yeasts Cryptococcus neoformans and C. gattii with high predilection to invade the central nervous system mainly in immunocompromised hosts. Skin can be secondarily involved in disseminated infection or be exceptionally involved as primary cutaneous infection by inoculation with contaminated materials. We report the first two Libyan cases of cryptococcal meningitis in HIV patients, in which one of them presented a secondary cutaneous involvement due to systemic dissemination...
May 30, 2017: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/28543626/smooth-semi-nonparametric-snp-estimation-of-the-cumulative-incidence-function
#8
Anh Nguyen Duc, Marcel Wolbers
This paper presents a novel approach to estimation of the cumulative incidence function in the presence of competing risks. The underlying statistical model is specified via a mixture factorization of the joint distribution of the event type and the time to the event. The time to event distributions conditional on the event type are modeled using smooth semi-nonparametric densities. One strength of this approach is that it can handle arbitrary censoring and truncation while relying on mild parametric assumptions...
May 23, 2017: Statistics in Medicine
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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