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cryptococcal antigene

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https://www.readbyqxmd.com/read/29771787/point-of-care-cryptococcal-antigen-screening-pipetting-finger-prick-blood-improves-performance-of-immuno-mycologics-lateral-flow-assay
#1
Rachel M Wake, Joseph N Jarvis, Thomas S Harrison, Nelesh P Govender
BACKGROUND: Cryptococcal antigen (CrAg) screening at point of care could improve cryptococcal meningitis prevention where laboratory resources are limited. We evaluated the accuracy of Immuno-Mycologics (IMMY, Norman, OK) CrAg lateral flow assay (LFA) using different techniques at point of care. SETTING: Two tertiary-level hospitals in Johannesburg and a community health clinic in Soweto, South Africa. METHODS: A case-control diagnostic validation study, and a prospective clinic-based implementation study using the IMMY CrAg LFA on finger-prick blood...
April 30, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29746320/false-negative-cryptococcal-antigen-test-due-to-the-postzone-phenomenon
#2
Noah Kojima, Mayamiko Chimombo, Daniel G Kahn
No abstract text is available yet for this article.
June 1, 2018: AIDS
https://www.readbyqxmd.com/read/29742199/diagnostic-and-therapeutic-strategies-in-cryptococcosis-impact-on-outcome
#3
Timothée Boyer Chammard, Elvis Temfack, Olivier Lortholary, Alexandre Alanio
Cryptococcosis diagnosis has been recently improved by the use of rapid cryptococcal antigen testing with lateral flow assays, which have proved sensitive and specific. Using "test and treat" screening strategies for cryptococcal disease with these tests has been showed effective in reducing cryptococcal meningitis (CM) in HIV-infected patients. Recommended induction, consolidation, and maintenance therapeutic strategy for CM is widely unavailable and/or expensive in low and middle-income settings...
2018: Memórias do Instituto Oswaldo Cruz
https://www.readbyqxmd.com/read/29662603/increased-mortality-among-hiv-infected-patients-with-cryptococcal-antigenemia-in-guinea-bissau
#4
Ditte Thomsen, Cecilie Juul Hviid, Bo Langhoff Hønge, Candida Medina, David Da Silva Té, Faustino Gomes Correira, Lars Østergaard, Christian Erikstrup, Christian Wejse, Alex Lund Laursen, Sanne Jespersen
Cryptococcal antigenemia may precede development of cryptococcal meningitis and death among patients with advanced HIV infection. Among 200 retrospectively and randomly selected ART-naïve patients with CD4 counts < 100 cells/μl from Guinea-Bissau, 20 (10%) had a positive cryptococcal antigen test. Self-reported headache and fever were predictors of a positive test, while cryptococcal antigenemia was a strong predictor of death within the first year of follow-up, MRR 2.22 (95% CI: 1.15-4.30). Screening for cryptococcal antigenemia should be implemented for patients with advanced HIV in Guinea-Bissau...
2018: Pan African Medical Journal
https://www.readbyqxmd.com/read/29593675/cryptococcal-antigen-screening-in-asymptomatic-hiv-infected-antiretroviral-na%C3%A3-ve-patients-in-cameroon-and-evaluation-of-the-new-semi-quantitative-biosynex-cryptops-test
#5
Elvis Temfack, Charles Kouanfack, Leonella Mossiang, Angela Loyse, Marie C Fonkoua, Síle F Molloy, Sinata Koulla-Shiro, Eric Delaporte, Françoise Dromer, Thomas Harrison, Olivier Lortholary
Background: Cryptococcal meningitis (CM) is a major cause of AIDS-related mortality in Africa. Detection of serum cryptococcal antigen (CrAg) predicts development of CM in antiretroviral (ART) naïve HIV-infected patients with severe immune depression. Systematic pre-ART CrAg screening and pre-emptive oral fluconazole is thus recommended. We postulated that a semi-quantitative CrAg screening approach could offer clinically relevant advantages. Methods: ART-naïve asymptomatic adult outpatients with <100 CD4 cells/mm3 presenting to the Yaoundé Central Hospital, Cameroon were screened for CrAg using the IMMY lateral flow assay (LFA)...
2018: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29583086/dual-infection-of-the-central-nervous-system-caused-by-cryptococcus-and-toxoplasma-in-a-patient-with-aids-a-case-report-and-literature-review
#6
Jose Armando Gonzales Zamora
Dual infection of the central nervous system secondary to Cryptococcus and Toxoplasma is very uncommon, even in the setting of acquired immunodeficiency syndrome (AIDS). We report the case of a 52-year-old patient who was admitted with multiple cranial nerve deficits. Magnetic resonance imaging showed supratentorial and infratentorial enhancing lesions. He was newly diagnosed with HIV infection with a CD4 count of 59 cells/uL and HIV viral load of 299,619 copies/mL. Diagnosis of Cryptococcus meningitis was made by Cryptococcal antigen in cerebrospinal fluid (CSF)...
March 27, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29514236/cd4-cell-count-threshold-for-cryptococcal-antigen-screening-of-hiv-infected-individuals-a-systematic-review-and-meta-analysis
#7
Nathan Ford, Zara Shubber, Joseph N Jarvis, Tom Chiller, Greg Greene, Chantal Migone, Marco Vitoria, Meg Doherty, Graeme Meintjes
Background: Current guidelines recommend screening all people living with human immunodeficiency virus (PLHIV) who have a CD4 count ≤100 cells/µL for cryptococcal antigen (CrAg) to identify those patients who could benefit from preemptive fluconazole treatment prior to the onset of meningitis. We conducted a systematic review to assess the prevalence of CrAg positivity at different CD4 cell counts. Methods: We searched 4 databases and abstracts from 3 conferences up to 1 September 2017 for studies reporting prevalence of CrAg positivity according to CD4 cell count strata...
March 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29514232/managing-advanced-hiv-disease-in-a-public-health-approach
#8
Nathan Ford, Graeme Meintjes, Alexandra Calmy, Helen Bygrave, Chantal Migone, Marco Vitoria, Martina Penazzato, Lara Vojnov, Meg Doherty
In 2017, the World Health Organization (WHO) published guidelines for the management of advanced human immunodeficiency virus (HIV) disease within a public health approach. Recent data suggest that more than a third of people starting antiretroviral therapy (ART) do so with advanced HIV disease, and an increasing number of patients re-present to care at an advanced stage of HIV disease following a period of disengagement from care. These guidelines recommend a standardized package of care for adults, adolescents, and children, based on the leading causes of morbidity and mortality: tuberculosis, severe bacterial infections, cryptococcal meningitis, toxoplasmosis, and Pneumocystis jirovecii pneumonia...
March 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29509588/a-prospective-evaluation-of-a-multisite-cryptococcal-screening-and-treatment-program-in-hiv-clinics-in-uganda
#9
Elizabeth Nalintya, David B Meya, Sarah Lofgren, Kathy Huppler Hullsiek, David R Boulware, Radha Rajasingham
BACKGROUND: Cryptococcus is a leading cause of AIDS-related mortality. Cryptococcal antigen (CrAg) is detectable in blood before meningitis onset and predicts death. CrAg screening among those with advanced HIV, and treatment of those CrAg+ with fluconazole, has demonstrated survival benefit. However, implementation and widespread uptake have been slow outside clinical trials. METHODS: We designed a CrAg screening program for routine care that incorporated intensive education and training of clinic staff...
June 1, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29451598/performance-of-cryptococcal-antigen-lateral-flow-assay-in-serum-cerebrospinal-fluid-whole-blood-and-urine-in-hiv-infected-patients-with-culture-proven-cryptococcal-meningitis-admitted-at-a-brazilian-referral-center
#10
José E Vidal, Carolina Toniolo, Adriana Paulino, Arnaldo L Colombo, Marilena Dos Anjos Martins, Cristina da Silva Meira, Renata Guise Soares Azevedo, Vera Lucia Pereira-Chioccola, Hélio Rodrigues Gomes, Marcia Dos Santos Lazera, Augusto C Penalva de Oliveira, David R Boulware
Cryptococcal meningitis is the most common cause of opportunistic meningitis in HIV-infected patients in Brazil and causes unacceptable high mortality rates. In this study, HIV-infected patients with a first episode of culture-proven cryptococcal meningitis in cerebrospinal fluid (CSF) were prospectively included in order to evaluate sensitivity of cryptococcal antigen (CrAg) lateral flow assay (LFA) in serum, CSF, whole blood (fingerstick), and fresh urine. In addition, HIV-infected patients with other neurological confirmed diseases were included in order to evaluate the specificity of CrAg LFA in serum...
2018: Revista do Instituto de Medicina Tropical de São Paulo
https://www.readbyqxmd.com/read/29422616/identification-of-t-helper-th-1-and-th2-associated-antigens-of-cryptococcus-neoformans-in-a-murine-model-of-pulmonary-infection
#11
Carolina Firacative, A Elisabeth Gressler, Kristin Schubert, Bianca Schulze, Uwe Müller, Frank Brombacher, Martin von Bergen, Gottfried Alber
Cryptococcosis, caused by Cryptococcus neoformans, has been demonstrated to be controlled by T helper (Th)1 cells while Th2 cells are associated with fungal growth and dissemination. Although cryptococcal immunoreactive protein antigens were previously identified, their association with Th1 or Th2 immune responses was not provided. In mice, Th1-dependent IFN-γ induces the production of IgG2a, whereas the Th2 cytokine IL-4 stimulates the expression of IgG1 rendering each isotype an indicator of the underlying Th cell response...
February 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29420767/evaluation-of-trypan-blue-stain-in-the-tc20-automated-cell-counter-as-a-point-of-care-for-the-enumeration-of-viable-cryptococcal-cells-in-cerebrospinal-fluid
#12
Richard Kwizera, Andrew Akampurira, Tadeo K Kandole, Maria S Nabaggala, Darlisha A Williams, Andrew Kambugu, David B Meya, Joshua Rhein, David R Boulware
Cerebrospinal fluid (CSF) culture can determine a quantitative viability of Cryptococcus yeasts; however, culture has a long turnaround-time. The TC20 automated cell counter (Bio-Rad) is a benchtop instrument used to count cells in 30 seconds. In vitro studies suggest trypan blue staining can distinguish between viable and dead cryptococcal yeasts. We hypothesized that trypan blue staining with automated cell counting may provide rapid quantification of viable CSF Cryptococcus yeasts. In sum, 96 HIV-infected participants with cryptococcal meningitis were enrolled and provided 194 CSF specimens in Kampala, Uganda...
October 9, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/29371546/monocyte-phenotype-and-ifn-%C3%AE-inducible-cytokine-responses-are-associated-with-cryptococcal-immune-reconstitution-inflammatory-syndrome
#13
David B Meya, Samuel Okurut, Godfrey Zziwa, Stephen Cose, Paul R Bohjanen, Harriet Mayanja-Kizza, Moses Joloba, David R Boulware, Carol Yukari Manabe, Sharon Wahl, Edward N Janoff
A third of adults with AIDS and cryptococcal meningitis (CM) develop immune reconstitution inflammatory syndrome (IRIS) after initiating antiretroviral therapy (ART), which is thought to result from exaggerated inflammatory antigen-specific T cell responses. The contribution of monocytes to the immunopathogenesis of cryptococcal IRIS remains unclear. We compared monocyte subset frequencies and immune responses in HIV-infected Ugandans at time of CM diagnosis (IRIS-Baseline) for those who later developed CM-IRIS, controls who did not develop CM-IRIS (Control-Baseline) at CM-IRIS (IRIS-Event), and for controls at a time point matched for ART duration (Control-Event) to understand the association of monocyte distribution and immune responses with cryptococcal IRIS...
June 2, 2017: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29343153/cryptococcal-infections-in-two-patients-receiving-ibrutinib-therapy-for-chronic-lymphocytic-leukemia
#14
Matthew Stankowicz, Megan Banaszynski, Russell Crawford
Cryptococcal infections are responsible for significant morbidity and mortality in immunocompromised patients. Reports of these infections in patients on small molecular kinase inhibitors have not been widely reported in clinical trials. We describe one case of cryptococcal meningoencephalitis and one case of cryptococcal pneumonia in two patients who were receiving ibrutinib for chronic lymphocytic leukemia. Despite different sites of cryptococcal infection, both patients had similar presentations of acute illness...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29338706/miliary-tuberculosis-with-co-existing-pulmonary-cryptococcosis-in-non-hiv-patient-without-underlying-diseases-a-case-report
#15
Toyomitsu Sawai, Takumi Nakao, Satoru Koga, Shotaro Ide, Sumako Yoshioka, Nobuko Matsuo, Hiroshi Mukae
BACKGROUND: Tuberculosis and cryptococcosis co-infection usually occurs in immunosuppressed patients with impaired cell-mediated immunity. However, there are few reports about such co-infection in non-HIV patients without underlying diseases. Here, we report a case of miliary tuberculosis with co-existing pulmonary cryptococcosis in non-HIV patient without underlying diseases. CASE PRESENTATION: An 84-year-old Asian female presented to our hospital with complaints of a 1-week history of abdominal pain and appetite loss...
January 16, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29319242/clinical-diversity-of-cns-cryptococcosis
#16
J M Koshy, S Mohan, D Deodhar, M John, A Oberoi, A Pannu
Background: Though cryptococcal meningitis (CM) is recognized as a disease of the immunocompromised, studies have implicated that it also affect immunocompetent patients. Methodology: This was a cross sectional study conducted in the Department of Medicine of a tertiary teaching institution in North India. All the patients diagnosed with CM on the basis of detection of cryptococcal antigen or the presence of capsulated budding yeast cells on India ink preparation, from April 2009 to March2015 were included in the study...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29304090/evaluation-of-a-point-of-care-immunoassay-test-kit-strongstep-for-cryptococcal-antigen-detection
#17
Edward Mpoza, Liliane Mukaremera, Didas Atwebembere Kundura, Andrew Akampurira, Tonny Luggya, Kiiza Kandole Tadeo, Katelyn A Pastick, Sarah C Bridge, Lillian Tugume, Reuben Kiggundu, Abdu K Musubire, Darlisha A Williams, Conrad Muzoora, Elizabeth Nalintya, Radha Rajasingham, Joshua Rhein, David R Boulware, David B Meya, Mahsa Abassi
BACKGROUND: HIV-associated cryptococcal meningitis is the leading cause of adult meningitis in Sub-Saharan Africa, accounting for 15%-20% of AIDS-attributable mortality. The development of point-of-care assays has greatly improved the screening and diagnosis of cryptococcal disease. We evaluated a point-of-care immunoassay, StrongStep (Liming Bio, Nanjing, Jiangsu, China) lateral flow assay (LFA), for cryptococcal antigen (CrAg) detection in cerebrospinal fluid (CSF) and plasma. METHODS: We retrospectively tested 143 CSF and 77 plasma samples collected from HIV-seropositive individuals with suspected meningitis from 2012-2016 in Uganda...
2018: PloS One
https://www.readbyqxmd.com/read/29302151/cryptococcal-meningitis-masquerading-as-normal-pressure-hydrocephalus-in-an-immune-competent-adult
#18
Hitesh Raheja, Ankur Sinha, Pavan Kumar Irukulla, Yizhak Kupfer
We report a case of acute cryptococcal meningitis (CM) masquerading as normal pressure hydrocephalus (NPH) in an immune-competent female. An 85-year-old human immunodeficiency virus-negative female presented to the emergency room for altered mental status and difficulty walking. She was increasingly lethargic, with urinary incontinence and gait instability. A previous computed tomography was reported to have ventricular dilatation out of proportion to the degree of cortical atrophy. Magnetic resonance scan of the brain revealed ventricular dilatation and subtle debris layering the occipital horns of the lateral ventricles...
October 2017: Journal of Global Infectious Diseases
https://www.readbyqxmd.com/read/29223998/cryptococcal-meningitis-in-apparently-immunocompetent-patients-association-with-idiopathic-cd4-lymphopenia
#19
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/29214004/prevalence-of-cryptococcal-antigen-positivity-among-hiv-infected-patient-with-cd4-cell-count-less-than-100-of-imam-khomeini-hospital-tehran-iran
#20
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
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