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Cryptococcal meningitis

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https://www.readbyqxmd.com/read/28068915/comparison-of-clinical-features-and-prognostic-factors-in-hiv-negative-adults-with-cryptococcal-meningitis-and-tuberculous-meningitis-a-retrospective-study
#1
Junyan Qu, Taoyou Zhou, Cejun Zhong, Rong Deng, Xiaoju Lü
BACKGROUND: The incidence of cryptococcal meningitis (CM) and tuberculous meningitis (TBM) have gradually increased in recent years. These two types of meningitis are easily misdiagnosed which leads to a poor prognosis. In this study we compared differences of clinical features and prognostic factors in non-HIV adults with CM and TBM. METHODS: We retrospectively reviewed the medical records of CM and TBM patients from January 2008 to December 2015 in our university hospital in China...
January 10, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28052943/corticosteroid-induced-cryptococcal-meningitis-in-patient-without-hiv
#2
Anand Nidhi, Alpana Meena, Arjun Sreekumar, Mradul Kumar Daga
Cryptococcus neoformans is the most frequent cause of fungal meningitis in humans. Cryptococcus affects people of all ages and has a worldwide distribution. It is the fourth most common infection in AIDS (CD4 counts <100/mm(3)). Cases also occur in patients with other forms of immunosuppression and in apparently immunocompetent individuals. Chronic high-dose steroid may precipitate such an immunocompromised state and thus create susceptibility to fungal infections. In our case, we describe a 14-year-old boy who was on steroids for tubercular meningitis for a period of 8 weeks after which he developed cryptococcal meningitis...
January 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28052761/increased-activity-of-the-complement-system-in-cerebrospinal-fluid-of-the-patients-with-non-hiv-cryptococcal-meningitis
#3
Lei Shen, Jianming Zheng, Yan Wang, Mengqi Zhu, Haoxiang Zhu, Qi Cheng, Qian Li
BACKGROUNDS: Cryptococcal meningitis (CM) has been known to lead to significant morbidity and mortality. The relative contribution of the complement system in protection and pathogenesis during CM remains largely unknown. The purpose of this study was to evaluate the baseline complement component profiles in human cerebrospinal fluid (CSF) and plasma from non-HIV patients with CM, and therefore to provide insights of possible roles of the complement system in CM. METHODS: CSF and blood samples from forty two CM patients not infected with HIV and thirteen non-CM control patients (Ctrl) were retrospectively selected and evaluated from the patients admitted to the hospital with a suspected diagnosis of CM...
January 4, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28050006/surgical-resection-during-chemotherapy-of-pulmonary-cryptococcoma-in-a-patient-with-cryptococcal-meningitis
#4
Yuji Tanaka, Kazuo Satomi
We herein report the case of a 72-year-old-man with pulmonary cryptococcoma along with cryptococcal meningitis who underwent surgery for pulmonary lesions while receiving chemotherapy. We noted two major clinical issues. First, the presence of pulmonary cryptococcoma had a detrimental influence on the cryptococcal meningitis. Second, resolution of the pulmonary cryptococcoma through antifungal therapy had a beneficial influence on the recovery from cryptococcal meningitis. As observed in the current case with pulmonary and meningeal cryptococcosis, surgery for pulmonary cryptococcoma with continuous antifungal treatment should be considered for cases where the symptoms respond poorly to antifungal therapy and radiographic abnormalities persist...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28031206/physiological-differences-in-c-neoformans-in-vitro-versus-in-vivo-and-their-effects-on-antifungal-susceptibility
#5
Nina T Grossman, Arturo Casadevall
Cryptococcus neoformans is an environmentally ubiquitous fungal pathogen that primarily causes disease in people with compromised immune systems, particularly those with advanced AIDS. There are estimated to be almost one million cases per year of cryptococcal meningitis in patients with human immunodeficiency virus, leading to over 600,000 annual deaths, with a particular burden in sub-Saharan Africa. Amphotericin B (AMB) and fluconazole (FLC) are key components of cryptococcal meningitis treatment: AMB is used for induction, FLC for consolidation, maintenance, and in occasional individuals, prophylaxis...
December 28, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28028491/cryptococcal-meningitis-associated-with-increased-adenosine-deaminase-in-the-cerebrospinal-fluid
#6
Yuji Tanaka, Kazuo Satomi
INTRODUCTION: Clinically, increased cerebrospinal fluid (CSF) adenosine deaminase (ADA) level is an important diagnostic clue of tuberculous meningitis. However, increased CSF ADA level can be caused by other neurological diseases. CASE DESCRIPTION: We report a case of a 67-year-old woman with cryptococcal meningitis presented with increased ADA level of the CSF. In parallel with her recovery, the ADA level of CSF decreased steadily. This is the first case described the chronological change in CSF ADA level of the patient with cryptococcal meningitis in detail...
2016: SpringerPlus
https://www.readbyqxmd.com/read/28018689/cryptococcus-gattii-in-an-immunocompetent-patient-in-the-southeastern-united-states
#7
John W Amburgy, Joseph H Miller, Benjamin J Ditty, Patrick Vande Lune, Shaaf Muhammad, Winfield S Fisher
Cryptococcal infections are seen throughout the United States in both immunocompromised and immunocompetent patients. The most common form is C. neoformans. In the Northwestern United States, C. gattii has received considerable attention secondary to increased virulence resulting in significant morbidity and mortality. There are no cases in the extant literature describing a patient with C. gattii requiring neurosurgical intervention in Alabama. A middle-aged immunocompetent male with no recent travel or identifiable exposure presented with meningitis secondary to C...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28017759/the-monro-kellie-doctrine-in-action-posterior-reversible-leukoencephalopathy-syndrome-pres-due-to-intracranial-hypotension-from-lumbo-peritoneal-shunt-placement
#8
Ioannis Karakis, Audrey H Nuccio, Jordan P Amadio, Arthur J Fountain
BACKGROUND: Posterior reversible leukoencephalopathy syndrome (PRES) is linked to various etiologies, foremost systemic hypertension. Its association with intracranial hypotension (IH), a potential sequela of various neurosurgical procedures, is under-recognized. We report a case of lumbo-peritoneal shunt induced IH resulting in PRES with the goal to increase awareness, and elaborate on the potential biological mechanism, based on the Monro-Kellie hypothesis. CASE DESCRIPTION: A 26-year-old woman with acquired immunodeficiency syndrome and epilepsy was admitted for recurrent cryptococcal meningitis and breakthrough seizures...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28013480/disseminated-cryptococcosis-due-to-anti-granulocyte-macrophage-colony-stimulating-factor-autoantibodies-in-the-absence-of-pulmonary-alveolar-proteinosis
#9
Chen-Yen Kuo, Shang-Yu Wang, Han-Po Shih, Kun-Hua Tu, Wen-Chi Huang, Jing-Ya Ding, Chia-Hao Lin, Chun-Fu Yeh, Mao-Wang Ho, Shi-Chuan Chang, Chi-Ying He, Hung-Kai Chen, Chen-Hsuan Ho, Chen-Hsiang Lee, Chih-Yu Chi, Cheng-Lung Ku
INTRODUCTION: Autoantibodies to granulocyte-macrophage colony-stimulating factor (GM-CSF) can cause acquired pulmonary alveolar proteinosis (PAP). Cases of acquired PAP susceptible to typical respiratory pathogens and opportunistic infections have been reported. Anti-GM-CSF autoantibodies have been reported in a few patients with cryptococcal meningitis. This study evaluated the presence of neutralizing anti-GM-CSF autoantibodies in patients without known congenital or acquired immunodeficiency with severe pulmonary or extrapulmonary cryptococcal infection but without PAP...
December 24, 2016: Journal of Clinical Immunology
https://www.readbyqxmd.com/read/27936983/molecular-diagnosis-of-invasive-mycoses-of-the-central-nervous-system
#10
Matthew William McCarthy, Thomas J Walsh
In September 2012, the Centers for Disease Control and Prevention (CDC) began investigating an outbreak of fungal meningitis among patients who had received contaminated preservative-free methyl prednisolone acetate injections from the New England Compounding Center in Framingham, Massachusetts. Thousands of patients were potentially exposed to tainted corticosteroids, but establishing the diagnosis of fungal meningitis during the nationwide outbreak was difficult because little was known about the natural history of the disease...
December 22, 2016: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/27919843/non-adherence-to-antiretroviral-therapy-in-patients-infected-with-hiv-and-cryptococcal-meningitis-two-cases-at-the-lambar%C3%A3-n%C3%A3-hospital-center-in-gabon
#11
U D Kombila, J Iba Ba, G Tsoumbou-Bakana, J-B Moussavou Kombila
Cryptococcal meningitis is a serious infection occurring mainly in immunodepressed patients, especially those with AIDS. Its incidence is growing among people living with HIV/AIDS who interrupt their antiretroviral treatment. We report two cases that occurred in this situation and had lethal outcomes in the short term. Testing for cryptococcal antigen in serum (serum CRAG test) enables a reliable and early diagnosis, and its use should be promoted in rural areas of sub-Saharan Africa.
December 5, 2016: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/27906037/integrated-therapy-for-hiv-and-cryptococcosis
#12
REVIEW
Sirawat Srichatrapimuk, Somnuek Sungkanuparph
Cryptococcosis has been one of the most common opportunistic infections and causes of mortality among HIV-infected patients, especially in resource-limited countries. Cryptococcal meningitis is the most common form of cryptococcosis. Laboratory diagnosis of cryptococcosis includes direct microscopic examination, isolation of Cryptococcus from a clinical specimen, and detection of cryptococcal antigen. Without appropriate treatment, cryptococcosis is fatal. Early diagnosis and treatment is the key to treatment success...
November 29, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27886201/cryptococcal-meningitis-epidemiology-immunology-diagnosis-and-therapy
#13
REVIEW
Peter R Williamson, Joseph N Jarvis, Anil A Panackal, Matthew C Fisher, Síle F Molloy, Angela Loyse, Thomas S Harrison
HIV-associated cryptococcal meningitis is by far the most common cause of adult meningitis in many areas of the world that have high HIV seroprevalence. In most areas in Sub-Saharan Africa, the incidence of cryptococcal meningitis is not decreasing despite availability of antiretroviral therapy, because of issues of adherence and retention in HIV care. In addition, cryptococcal meningitis in HIV-seronegative individuals is a substantial problem: the risk of cryptococcal infection is increased in transplant recipients and other individuals with defects in cell-mediated immunity, and cryptococcosis is also reported in the apparently immunocompetent...
January 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/27875016/cryptococcal-infections-in-solid-organ-transplant-recipients-over-a-15-year-period-at-a-state-transplant-center
#14
Ian Gassiep, David McDougall, Joel Douglas, Ross Francis, Elliott G Playford
BACKGROUND: The aim of this research paper is to determine the incidence, risk factors and clinical outcome of solid organ transplant (SOT) recipients diagnosed and treated for cryptococcosis at our institution. METHODS: Retrospective analysis of all patients with SOT diagnosed and treated for cryptococcal infection occurring between January 2001 and December 2015. RESULTS: Of 102 patients diagnosed with cryptococcal infection, 23 were SOT recipients...
November 22, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27862555/genomic-epidemiology-of-cryptococcus-yeasts-identifies-adaptation-to-environmental-niches-underpinning-infection-across-an-african-hiv-aids-cohort
#15
Mathieu Vanhove, Mathew A Beale, Johanna Rhodes, Duncan Chanda, Shabir Lakhi, Geoffrey Kwenda, Sile Molloy, Natasha Karunaharan, Neil Stone, Thomas S Harrison, Tihana Bicanic, Matthew C Fisher
Emerging infections caused by fungi have become a widely recognized global phenomenon and are causing an increasing burden of disease. Genomic techniques are providing new insights into the structure of fungal populations, revealing hitherto undescribed fine-scale adaptations to environments and hosts that govern their emergence as infections. Cryptococcal meningitis is a neglected tropical disease that is responsible for a large proportion of AIDS-related deaths across Africa; however, the ecological determinants that underlie a patient's risk of infection remain largely unexplored...
October 19, 2016: Molecular Ecology
https://www.readbyqxmd.com/read/27852678/disseminated-cryptococcosis-in-an-immunocompetent-child
#16
Noora Saeed, Hena A Ansari, Nazoora Khan, Mohsin Aijaz
Cryptococcus is a ubiquitous fungus and is known for causing meningitis and cutaneous infections in immunocompromised individuals. Disseminated cryptococcal infection is very rare and almost always found to occur in immunocompromised individuals especially in persons infected with HIV. This is particularly attributed to its capsulated spores. But there are few reported cases in which it has been found to cause disseminated infections even in immunocompetent individuals. We report a similar case of disseminated cryptococcal infection in an immunocompetent host...
November 16, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27818191/corticosteroids-for-the-management-of-severe-intracranial-hypertension-in-meningoencephalitis-caused-by-cryptococcus-gattii-a-case-report-and-review
#17
R-A Maciel, L-S Ferreira, F Wirth, P-D Rosa, M Aves, E Turra, L-Z Goldani
Immune reconstitution inflammatory syndrome in meningitis caused by Cryptococcus gattii in immunocompetent patients after initiation of antifungal therapy appears to be the result of paradoxical antifungal treatment-induced clinical deterioration due to improved local immune responses to cryptococcal organisms. Recent anecdotal reports have suggested a favorable clinical response to corticosteroids in select patients with C. gattii central nervous system (CNS) infections. In this report, we describe a 65-year-old patient with meningoencephalitis caused by C...
November 3, 2016: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/27814690/characteristics-and-outcomes-of-cryptococcal-meningitis-in-hiv-seronegative-children-in-beijing-china-2002-2013
#18
Ling-Yun Guo, Lin-Lin Liu, Yue Liu, Tian-Ming Chen, Shao-Ying Li, Yong-Hong Yang, Gang Liu
BACKGROUND: Data regarding HIV-seronegative pediatric patients with cryptococcal meningitis (CM) have been very limited. METHODS: We retrospectively reviewed non-HIV-infected in patients with CM from January 2002 through December 2013 in Beijing Children's Hospital. Records of the all patients were obtained and compared. RESULTS: The 34 children had a median age of 5.6 years. Most of the patients were male (67.6 %). Only 23.5 % of the cases had identifiable underlying diseases...
November 4, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27807560/posterior-reversible-encephalopathy-syndrome-and-fatal-cryptococcal-meningitis-after-immunosuppression-in-a-patient-with-elderly-onset-inflammatory-bowel-disease
#19
Dipesh H Vasant, Jimmy K Limdi, Simon P Borg-Bartolo, Alec Bonington, Regi George
Advanced age and associated comorbidities are-recognized predictors of life-threatening adverse outcomes, such as opportunistic infection following immunosuppressive therapy. We describe the case of an elderly patient with stricturing colonic Crohn's disease and significant clinical comorbidities, initially controlled with corticosteroid induction followed by infliximab, whose course was complicated by fatal disseminated cryptococcal infection and posterior reversible encephalopathy syndrome. Our patient's case highlights rare, but serious, complications of immunosuppression...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27789254/estimating-the-burden-of-invasive-and-serious-fungal-disease-in-the-united-kingdom
#20
Matthew Pegorie, David W Denning, William Welfare
BACKGROUND: The burden of fungal disease in the UK is unknown. Only limited data are systematically collected. We have estimated the annual burden of invasive and serious fungal disease. METHODS: We used several estimation approaches. We searched and assessed published estimates of incidence, prevalence or burden of specific conditions in various high risk groups. Studies with adequate internal and external validity allowed extrapolation to estimate current UK burden...
January 2017: Journal of Infection
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