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Cryptococcal meningitis

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https://www.readbyqxmd.com/read/28700464/cryptococcal-meningitis-after-transnasal-transsphenoidal-pituitary-microsurgery-of-acth-secreting-pituitary-adenoma-a-case-report
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28661942/nursing-management-of-lumbar-drainage-in-cryptococcal-meningitis-a-case-report
#7
Ling Ling, Lu Guo, Jingjuan Wang, Lili Zhang, Jie Zhu, Zhiyu Huang
Raised intracranial pressure is a hallmark of cryptococcal meningitis and is associated with increased mortality. Continuous drainage of lumbar cerebrospinal fluid is suggested to control intracranial pressure. The complications induced by this treatment have been described. However, nursing care associated with identification and management of complications is less well known. We encountered a patient with human immunodeficiency virus-negative cryptococcal meningitis who developed increasing cerebrospinal fluid pressure, hearing impairment, and limb weakness...
August 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28631642/sporadic-occurrence-of-cryptococcal-meningitis-in-hiv-seronegative-patients-uncommon-etiology
#8
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
#9
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
#10
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
#11
COMPARATIVE STUDY
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 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
#12
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
#13
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
#14
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
#15
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...
August 15, 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
#16
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
#17
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
#18
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
#19
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
#20
Izabel Almeida Alves, Keli Jaqueline Staudt, Carolina de Miranda Silva, Graziela de Araujo Lock, Teresa Dalla Costa, Bibiana Verlindo de Araujo
To make advances in the treatment of cryptococcal meningitis, it is crucial to know a given drug's free fraction that reaches the biophase. In the present study, we applied microdialysis (μD) as a tool to determine the free levels reached by voriconazole (VRC) in the brains of healthy and Cryptococcus neoformans-infected rats. The infection was induced by the intravenous (i.v.) administration of 1 × 10(5) CFU of yeast. The dose administered was 5 mg/kg (of body weight) of VRC, given i.v. Plasma and microdialysate samples were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and LC-UV methods...
July 2017: Antimicrobial Agents and Chemotherapy
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