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Cryptococcal meningitis

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https://www.readbyqxmd.com/read/29223998/cryptococcal-meningitis-in-apparently-immunocompetent-patients-association-with-idiopathic-cd4-lymphopenia
#1
Samuel Shribman, Alastair Noyce, Sharmilee Gnanapavan, Jonathan Lambourne, Thomas Harrison, Frederick Schon
We present two cases of cryptococcal meningitis in people subsequently diagnosed with idiopathic CD4+ lymphopenia. Both presented with new onset headaches without sinister features and were sent home on multiple occasions from emergency departments. Cryptococcal meningitis in HIV-negative patients poses major diagnostic and management problems; the associated mortality is 9%-27%. We suggest performing blood and cerebrospinal fluid cryptococcal antigen tests in all people with lymphocytic meningitis.
December 9, 2017: Practical Neurology
https://www.readbyqxmd.com/read/29218468/prediction-of-unfavorable-outcomes-in-cryptococcal-meningitis-results-of-the-multicenter-infectious-diseases-international-research-initiative-id-iri-cryptococcal-meningitis-study
#2
I N Hakyemez, H Erdem, G Beraud, M Lurdes, A Silva-Pinto, C Alexandru, B Bishop, F Mangani, X Argemi, M Poinot, R Hasbun, M Akcaer, S Alp, T Demirdal, K Angamuthu, F Amer, E Ragab, G A Shehata, D Ozturk-Engin, N Ozgunes, L Larsen, S Zimmerli, O R Sipahi, E Tukenmez Tigen, G Celebi, N Oztoprak, A C Yardimci, Y Cag
Cryptococcal meningitis (CM) is mostly seen in immunocompromised patients, particularly human immunodeficiency virus (HIV)-positive patients, but CM may also occur in apparently immunocompetent individuals. Outcome analyses have been performed in such patients but, due to the high prevalence of HIV infection worldwide, CM patients today may be admitted to hospitals with unknown HIV status, particularly in underdeveloped countries. The objective of this multicenter study was to analyze all types of CM cases in an aggregate cohort to disclose unfavorable outcomes...
December 8, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29214004/prevalence-of-cryptococcal-antigen-positivity-among-hiv-infected-patient-with-cd4-cell-count-less-than-100-of-imam-khomeini-hospital-tehran-iran
#3
Mahboobeh Hajiabdolbaghi, Saeed Kalantari, Mahin Jamshidi-Makiani, Esfandiar Shojaei, Ladan Abbasian, Mehrnaz Rasoulinezhad, Katayoun Tayeri
Background and Objectives: Cryptococcal meningitis is one of the main opportunistic infections associated with human immunodeficiency virus (HIV) infection. Despite the present and increasingly availability of specific treatment for cryptococcosis, the mortality rate of this infection is still high, particularly in patients with advanced immunsupression and advanced cryptococcal diseases. Materials and Methods: This Prospective Cohort study was conducted at Imam Khomeini hospital in Tehran, Iran...
April 2017: Iranian Journal of Microbiology
https://www.readbyqxmd.com/read/29189676/disseminated-cryptococcosis-with-severe-increased-intracranial-pressure-complicated-with-cranial-nerve-palsy-in-a-child
#4
Bilge Aldemir Kocabaş, Mehmet Emin Parlak, Betil Özhak Baysan, Kamil Karaali, Ayşen Bingöl, Şenay Haspolat
Cryptococcosis is less common in children than adults but remains an important cause of pneumonia and meningoencephalitis in both immunocompromised and immunocompetent patients. Intracranial hypertension commonly complicates cryptococcal meningitis and may cause significant visual and neurological morbidity and mortality. Early and aggressive management of intracranial hypertension in accordance with established guidelines reduces the risk of long term complications and death. In this case report, we present a 12-year-old girl with cryptococcal meningitis, pneumonitis and dermatitis complicated with cranial nerve palsy and loss of vision...
November 17, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29184338/rapid-clinical-score-for-the-diagnosis-of-tuberculous-meningitis-a-retrospective-cohort-study
#5
Raluca Jipa, Ioana D Olaru, Eliza Manea, Simona Merisor, Adriana Hristea
Objective: The aim of our study was to retrospectively validate a previously described rapid clinical score (RCS) in distinguishing tuberculous meningitis (TBM) from viral meningitis (VM) in people who are at increased risk of tuberculosis, as well as from cryptococcal meningitis (CM) in HIV-infected patients. Methods: We performed a retrospective study of patients admitted with a diagnosis of aseptic meningitis between January 2012 and December 2015, to a referral hospital for infectious diseases...
October 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/29154044/modulating-host-immune-responses-to-fight-invasive-fungal-infections
#6
REVIEW
James E Scriven, Mark W Tenforde, Stuart M Levitz, Joseph N Jarvis
Modulation of host immunity in invasive fungal infection is an appealing but as yet mostly elusive treatment strategy. Animal studies in invasive candidiasis and aspergillosis have demonstrated beneficial effects of colony stimulating factors, interferon-gamma and monoclonal antibodies. More recent studies transfusing leukocytes pre-loaded with lipophilic anti-fungal drugs, or modulated T-cells, along with novel vaccination strategies show great promise. The translation of immune therapies into clinical studies has been limited to date but this is changing and the results of new Candida vaccine trials are eagerly awaited...
November 15, 2017: Current Opinion in Microbiology
https://www.readbyqxmd.com/read/29142539/values-of-magnetic-resonance-imaging-and-cerebrospinal-fluid-analysis-in-the-diagnosis-of-central-nervous-system-associated-infectious-diseases
#7
Dongfeng Zhang
Objective: To discuss the roles of magnetic resonance imaging (MRI) and cerebrospinal fluid analysis in the identification of central nervous system associated infection and provide a reference for the diagnosis and treatment of central nervous system associated infectious diseases. Methods: Seventy-six patients who developed central nervous system infection and were admitted into the Henan People's Hospital between June 2014 and October 2015 were randomly selected as an observation group...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29142521/fatal-infections-in-older-patients-with-inflammatory-bowel-disease-on-anti-tumor-necrosis-factor-therapy
#8
Way-Seah Lee, Najib Azmi, Ruey-Terng Ng, Sik-Yong Ong, Sasheela Sri La Ponnampalavanar, Sanjiv Mahadeva, Ida Hilmi
Anti-tumor necrosis factor (anti-TNF) is highly effective in inflammatory bowel disease (IBD); however, it is associated with an increased risk of infections, particularly in older adults. We reviewed 349 patients with IBD, who were observed over a 12-month period, 74 of whom had received anti-TNF therapy (71 patients were aged <60 years and 3 were aged ≥60 years). All the 3 older patients developed serious infectious complications after receiving anti-TNFs, although all of them were also on concomitant immunosuppressive therapy...
October 2017: Intestinal Research
https://www.readbyqxmd.com/read/29129578/cryptococcosis-in-an-infectious-diseases-hospital-of-buenos-aires-argentina-revision-of-2041-cases-diagnosis-clinical-features-and-therapeutics
#9
Alicia Arechavala, Ricardo Negroni, Fernando Messina, Mercedes Romero, Emmanuel Marín, Roxana Depardo, Laura Walker, Gabriela Santiso
BACKGROUND: Cryptococcosis is still a life-threatening mycosis that continues to be of serious concern in Latin American countries, especially among HIV+positive population. However, there is not any reliable information about the prevalence of this disease in this region. AIMS: The aim of this study is to report data of 2041 patients with cryptococcosis that were attended at the Infectious Diseases Hospital F. J. Muñiz over a 30 year-period. METHODS: Information about demographic and clinical data, survival time and the applied treatment, was taken from the Mycology Unit database...
November 9, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/29123886/sudden-cerebral-depression-detected-by-bispectral-index-monitoring-in-cryptococcal-meningitis-with-elevated-near-fatal-cerebrospinal-fluid-pressure
#10
Hironori Matsumoto, Suguru Annen, Kensuke Umakoshi, Jun Takeba, Satoshi Kikuchi, Yuki Nakabayashi, Naoki Moriyama, Muneaki Ohshita, Mayuki Aibiki
Case: An increase in cerebrospinal fluid pressure (CSFP) is usually prominent in cryptococcal meningitis, which has a high mortality rate, so aggressive management to control CSFP is crucial. In this case, a 40-year-old-man survived cryptococcal meningitis treated with continuous spinal drainage under bispectral index (BIS) monitoring. He unexpectedly showed hypertension, went into a coma, and even loss his light reflexes due to CSFP elevation. His BIS values had abruptly dropped before developing these symptoms, but dramatically recovered after lumbar puncture drainage, suggesting that BIS monitoring could reflect cerebral function changes due to CSFP alternations...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29116307/cryptococcoma-mimicking-a-brain-tumor-in-an-immunocompetent-patient-case-report-of-an-extremely-rare-presentation
#11
Aline Lariessy Campos Paiva, Guilherme Brasileiro de Aguiar, Renan Maximilian Lovato, Arthus Vilar Deolindo Zanetti, Alexandros Theodoros Panagopoulos, José Carlos Esteves Veiga
CONTEXT: Central nervous system (CNS) infectious diseases have high prevalence in developing countries and their proper diagnosis and treatment are very important for public health planning. Cryptococcus neoformans is a fungus that may cause several CNS manifestations, especially in immunocompromised patients. Cryptococcal meningitis is the most common type of involvement. Mass-effect lesions are uncommon: they are described as cryptococcomas and their prevalence is even lower among immunocompetent patients...
November 6, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/29093251/-magnetic-resonance-imaging-features-of-cryptococcus-infection-in-central-nervous-system-in-patients-with-aids
#12
Chuanjun Xu, Zhiliang Hu, Hongxia Wei, Yongfeng Yang, Chao Du, Jianping Gu
To investigate the magnetic resonance imaging (MRI) features of Cryptococcus infection in central nervous system patients with acquired immune deficiency syndrome (AIDS).
 Methods: The retrospective study on magnetic resonance imaging (MRI) and clinical data of cryptococcal meningitis (CM) was carried out between July 2011 and March 2017. These patients had not received anti-retroviral treatment. Patients with other specific or suspicious diseases in the central nervous system were not included in the analysis...
October 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29069886/liquid-based-cytology-of-the-cerebrospinal-fluid-in-a-case-of-cryptococcal-meningitis
#13
Jiwoon Choi, Se Hoon Kim
Cryptococcus neoformans is the most common microorganism found in cerebrospinal fluid (CSF) cytology and causes life-threatening infections in immunocompromised hosts. Although its cytomorphologic features in conventional smear cytology have been well described, those in liquid-based cytology have rarely been. A 73-year-old woman with diffuse large B-cell lymphoma presented with mental confusion and a spiking fever. To rule out infectious conditions, CSF examination was performed. A cytology slide that was prepared using the ThinPrep method showed numerous spherical yeast-form organisms with diameters of 4-11 μm and thick capsules...
October 26, 2017: Journal of Pathology and Translational Medicine
https://www.readbyqxmd.com/read/29058791/in-vitro-and-in-vivo-effect-of-pd-1-pd-l1-blockade-on-microglia-macrophage-activation-and-t-cell-subset-balance-in-cryptococcal-meningitis
#14
Yuan-Mei Che, Yi Zhang, Ming Li, Xiao-Peng Li, Lun-Li Zhang
This study aimed to investigate the PD-1/ PD-L1 signaling pathway and its effects the activation of microglia/macrophage and balancing T cell subsets in cryptococcal meningitis (CM). A total of 126 CM patients and 126 healthy individuals were recruited for the study. The CM patients were treated with amphotericin B (AmB). Seventy five C57BL/6 mice were grouped into the normal control, CM model, CM + AmB, sham and CM + PD-1 antibodies (Ab) groups. CD4(+) and CD8(+) T cells as well as microglia/macrophages were analyzed by means of flow cytometry...
October 23, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/29058407/antifungal-phenothiazines-optimization-characterization-of-mechanism-and-modulation-of-neuroreceptor-activity
#15
Marhiah C Montoya, Louis DiDone, Richard F Heier, Marvin J Meyers, Damian J Krysan
New classes of antifungal drugs are an urgent unmet clinical need. One approach to the challenge of developing new antifungal drugs is to optimize the antifungal properties of currently used drugs with favorable pharmacologic properties, so-called drug or scaffold repurposing. New therapies for cryptococcal meningitis are particularly important given its worldwide burden of disease and limited therapeutic options. We report the first systematic structure-activity study of the anticryptococcal properties of the phenothiazines...
November 2, 2017: ACS Infectious Diseases
https://www.readbyqxmd.com/read/29048509/plasma-but-not-cerebrospinal-fluid-interleukin-7-and-interleukin-5-levels-pre-antiretroviral-therapy-commencement-predict-cryptococcosis-associated-immune-reconstitution-inflammatory-syndrome
#16
Ngomu Akeem Akilimali, Christina C Chang, Daniel M Muema, Tarylee Reddy, Mahomed-Yunus S Moosa, Sharon R Lewin, Martyn A French, Thumbi Ndung'u
Background: Patients with human immunodeficiency virus/AIDS-associated cryptococcal meningitis (CM) frequently experience clinical deterioration, known as cryptococcosis-associated immune reconstitution inflammatory syndrome (C-IRIS), upon initiation of antiretroviral therapy (ART). The immunological mechanisms underlying C-IRIS are incompletely defined and no reliable predictive biomarkers exist. We investigated whether plasma or cerebrospinal fluid (CSF) levels of cytokines and chemokines predicted C-IRIS and are potential predictive biomarkers...
October 16, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29046746/perspectives-on-non-neoformans-cryptococcal-opportunistic-infections
#17
REVIEW
Nichole Smith, Matthew Sehring, Jefferson Chambers, Preeti Patel
Non-neoformans Cryptococcus species, including C. laurentii and C. albidus, have historically been classified as exclusively saprophytic. However, recent studies have increasingly implicated these organisms as the causative agent of opportunistic infections in humans. Herein, the case is presented of C. laurentii meningitis in a critically ill patient receiving corticosteroids. C. laurentii has been implicated in an additional 18 cases of opportunistic infection, predominantly of the skin, bloodstream, and central nervous system...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29028998/high-cryptococcal-antigen-titers-in-blood-are-predictive-of-subclinical-cryptococcal-meningitis-among-hiv-infected-patients
#18
Rachel M Wake, Erika Britz, Charlotte Sriruttan, Ivy Rukasha, Tanvier Omar, David C Spencer, Jeremy S Nel, Sello Mashamaite, Adeboye Adelekan, Tom M Chiller, Joseph N Jarvis, Thomas S Harrison, Nelesh P Govender
Background: High mortality rates among asymptomatic cryptococcal antigen (CrAg)-positive patients identified through CrAg screening, despite pre-emptive fluconazole, may be due to undiagnosed cryptococcal meningitis. Methods: Symptoms were reviewed in CrAg-positive patients identified through screening 19,233 individuals with CD4 cell counts < 100 cells/µL at 17 clinics and 3 hospitals in Johannesburg from September 2012 until September 2015, and 2 of these hospitals until June 2016...
October 5, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29028957/long-term-mortality-and-disability-in-cryptococcal-meningitis-a-systematic-literature-review
#19
Estelle Pasquier, John Kunda, Pierre De Beaudrap, Angela Loyse, Elvis Temfack, Síle F Molloy, Thomas S Harrison, Olivier Lortholary
Cryptococcal meningitis (CM) is the primary cause of meningitis in HIV-infected adults and an emerging disease in HIV-seronegative individuals. No literature review has studied the long-term outcome of CM. We performed a systematic review on the long-term (≥3 months) impact of CM (C. neoformans and C. gattii) on mortality and disability in HIV-infected and non-HIV-infected adults. Though the quality of current evidence is limited, the long-term impact of CM on survival and disability appears to be high. One-year mortality ranged from 13% in an Australian non-HIV C...
October 4, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29021643/cryptococcal-cerebellitis-in-no-vih-patient
#20
Fabricio Andres Lasso, Tomas Omar Zamora Bastidas, Jorge Andrés Potosí García, Bairon Díaz Idrobo
INTRODUCTION: Cryptococcosis is an opportunistic fungal infection whose etiology is Cryptococcus neofromans / C. gattii, complex which affects immunocompromised patients mainly. Meningeal infection is one of the most common presentations, but cerebellar affection is rare. CASE DESCRIPTION: Male patient with 65 old years, from an area of subtropical climate with chronic exposure to poultry, without pathological antecedents, who presented clinical picture consistent with headache, fever, seizures and altered mental status...
June 30, 2017: Colombia Médica: CM
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