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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/28617817/prevalence-of-cryptococcal-infection-among-advanced-hiv-patients-in-argentina-using-lateral-flow-immunoassay
#2
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/28606065/neurocognitive-function-in-hiv-infected-persons-with-asymptomatic-cryptococcal-antigenemia-a-comparison-of-three-prospective-cohorts
#3
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/28584988/methodology-for-anti-cryptococcal-vaccine-development
#4
Ashok K Chaturvedi, Floyd L Wormley
Cryptococcus neoformans and Cryptococcus gattii, the predominant etiological agents of cryptococcosis, are fungal pathogens that cause disease ranging from a mild pneumonia to life-threatening infections of the central nervous system (CNS). C. neoformans is widely considered an opportunistic fungal pathogen which targets individuals with impaired immune systems, while C. gattii is predominantly associated with fungal infections in immunocompetent individuals. However, C. neoformans and C. gattii have certainly been identified as the causative agent of cryptococcosis in both immune compromised and immune competent individuals...
2017: Methods in Molecular Biology
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
#5
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/28566315/low-cryptococcus-antigen-titers-by-a-lateral-flow-assay-should-be-interpreted-cautiously-in-patients-without-a-prior-diagnosis-of-cryptococcal-infection
#6
Marie Dubbels, Dane Granger, Elitza S Theel
Detection of Cryptococcus antigen (CrAg) is invaluable for establishing cryptococcal disease. Multiple different methods for CrAg detection are available, including a lateral flow assay (LFA). Despite excellent performance of the CrAg LFA, we have observed multiple cases of low-titer (≤1:5) CrAg LFA positive results in patients for whom cryptococcosis was ultimately excluded. To investigate the accuracy of low-titer positive CrAg LFA results, we performed chart reviews on all CrAg LFA positive patients between June 2014 and December 2016...
May 31, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28562416/cryptococcal-disease-in-the-solid-organ-transplant-setting-review-of-clinical-aspects-with-a-discussion-of-asymptomatic-cryptococcal-antigenemia
#7
Noah Wald-Dickler, Emily Blodget
PURPOSE OF REVIEW: Cryptococcal infections are an important cause of morbidity and mortality in solid organ transplant patients. Here, we review the microbiology, epidemiology, clinical course, treatment, and outcomes of Cryptococcus in solid organ transplant recipients. RECENT FINDINGS: We identify the unique findings in solid organ transplant patients when compared to other immunocompromised patients such as those with HIV. We also describe our experience and outcomes with regard to solid organ transplant patients who do not have positive fungal cultures, but cryptococcal antigen positivity and concern for cryptococcal disease...
May 29, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28532447/clinical-characteristics-of-disseminated-cryptococcosis-in-previously-healthy-children-in-china
#8
Li-Wei Gao, An-Xia Jiao, Xi-Rong Wu, Shun-Ying Zhao, Yun Ma, Gang Liu, Ju Yin, Bao-Ping Xu, Kun-Ling Shen
BACKGROUND: Disseminated cryptococcosis is a rare and fatal disease, and limited data exist regarding it in children. This study aimed to investigate the clinical characteristics of disseminated cryptococcosis in previously healthy children in China. METHODS: Hospitalized patients with disseminated cryptococcosis were enrolled during January 1996 to December 2015 in Beijing Children's Hospital, Capital Medical University, China. Data on clinical manifestations, laboratory tests, treatment, and prognosis were evaluated...
May 22, 2017: BMC Infectious Diseases
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/28527157/cryptococcal-antigen-detection-in-serum-significance-as-a-screening-modality-for-indian-plhiv
#10
Smrati Bajpai
No abstract text is available yet for this article.
April 2017: Journal of the Association of Physicians of India
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/28493865/preheating-of-urine-improves-the-specificity-of-urinary-cryptococcal-antigen-testing-using-the-lateral-flow-assay
#12
Fábio Brito-Santos, Marcela de Faria Ferreira, Luciana Trilles, Mauro de Medeiros Muniz, Valdiléa Gonçalves Veloso Dos Santos, Filipe Anibal Carvalho-Costa, Wieland Meyer, Bodo Wanke, Márcia Dos Santos Lazéra
No abstract text is available yet for this article.
May 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28483415/global-burden-of-disease-of-hiv-associated-cryptococcal-meningitis-an-updated-analysis
#13
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/28419364/examination-of-cryptococcal-glucuronoxylomannan-antigen-in-bronchoalveolar-lavage-fluid-for-diagnosing-pulmonary-cryptococcosis-in-hiv-negative-patients
#14
Kazuhiro Oshima, Takahiro Takazono, Tomomi Saijo, Masato Tashiro, Shintaro Kurihara, Kazuko Yamamoto, Yoshifumi Imamura, Taiga Miyazaki, Misuzu Tsukamoto, Katsunori Yanagihara, Hiroshi Mukae, Shigeru Kohno, Koichi Izumikawa
We clarified the performance of a cryptococcal glucuronoxylomannan (GXM) antigen test using bronchoalveolar lavage fluid (BALF) samples, in an HIV-negative Japanese population. Between March 2008 and December 2014, we examined cryptococcal GXM antigens in both serum and BALF specimens from 429 cases at Nagasaki University hospital. The diagnoses, underlying diseases, chest computed tomography findings, and cryptococcal GXM antigen test results were retrospectively investigated. Twenty-three patients were confirmed to have pulmonary cryptococcosis, another six were clinically diagnosed with cryptococcosis because they were seropositive for the GXM antigen, and five possible cryptococcosis cases had BALF samples that were positive for the GXM antigen and serum samples that were negative...
April 17, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/28414687/disseminated-cryptococcal-disease-with-diffuse-pulmonary-infiltrates-in-a-non-hiv-host
#15
M Hughes, K Trivedi, M Rudrappa
INTRODUCTION: We present a case of disseminated Cryptococcus in a non-HIV host, where the primary manifestation was pulmonary with diffuse pulmonary infiltrates. This patient was on high dose corticosteroids for autoimmune hemolytic anemia. CASE: A 79 year old Caucasian man with a history of autoimmune hemolytic anemia on 100 mg of prednisone daily, coronary artery disease s/p bypass surgery, ischemic cardiomyopathy, chronic obstructive pulmonary disease, sleep apnea, chronic kidney disease, and history of bilateral pulmonary emboli presented to Hematology/Oncology clinic with symptoms of productive cough, worsening shortness of breath, hemoptysis...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28384860/fungal-opportunistic-pneumonias-in-hiv-aids-patients-an-indian-tertiary-care-experience
#16
Ravinder Kaur, Bhanu Mehra, Megh Singh Dhakad, Ritu Goyal, Preena Bhalla, Richa Dewan
INTRODUCTION: Opportunistic pneumonias are a major cause of mortality and morbidity in Human Immunodeficiency Virus (HIV) reactive patients. Despite the significant role that fungi play in causation of this opportunistic mycoses, very few Indian studies have attempted to investigate the burden and aetiological spectrum of HIV/AIDS-associated fungal pneumonias. AIM: To document the prevalence of fungal aetiology in HIV/AIDS-related opportunistic pneumonias in an Indian setting; and to elucidate the various fungal opportunists responsible for the same...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28362939/primary-prophylaxis-for-cryptococcosis-with-fluconazole-in-human-immunodeficiency-virus-infected-patients-with-cd4-t-cell-counts-100-cells-%C3%A2%C2%B5l-and-receiving-antiretroviral-therapy
#17
Somnuek Sungkanuparph, Chutchaiwat Savetamornkul, Warisara Pattanapongpaiboon
A prospective observational cohort study was conducted in 302 human immunodeficiency virus-infected patients who had a CD4 T-cell count <100 cells/µL and negative serum cryptococcal antigen initiating antiretroviral therapy in a resource-limited setting. During 2-year follow-up, there were no differences of survival rates and occurrences of newly diagnosed cryptococcosis between patients with and without fluconazole for primary prophylaxis of cryptococcosis.
April 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28335769/cost-effectiveness-of-crag-lfa-screening-for-cryptococcal-meningitis-among-people-living-with-hiv-in-uganda
#18
Anu Ramachandran, Yukari Manabe, Radha Rajasingham, Maunank Shah
BACKGROUND: Cryptococcal meningitis (CM) constitutes a significant source of mortality in resource-limited regions. Cryptococcal antigen (CRAG) can be detected in the blood before onset of meningitis. We sought to determine the cost-effectiveness of implementing CRAG screening using the recently developed CRAG lateral flow assay in Uganda compared to current practice without screening. METHODS: A decision-analytic model was constructed to compare two strategies for cryptococcal prevention among people living with HIV with CD4 < 100 in Uganda: No cryptococcal screening vs...
March 23, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28329080/differences-in-immunologic-factors-among-patients-presenting-with-altered-mental-status-during-cryptococcal-meningitis
#19
RANDOMIZED CONTROLLED TRIAL
Sarah Lofgren, Kathy H Hullsiek, Bozena M Morawski, Henry W Nabeta, Reuben Kiggundu, Kabanda Taseera, Abdu Musubire, Charlotte Schutz, Mahsa Abassi, Nathan C Bahr, Lillian Tugume, Conrad Muzoora, Darlisha A Williams, Melissa A Rolfes, Sruti S Velamakanni, Radha Rajasingham, Graeme Meintjes, Joshua Rhein, David B Meya, David R Boulware
Altered mental status in cryptococcal meningitis results in poorer survival, but underlying causes of altered mentation are poorly understood. Within two clinical trials, we assessed risk factors for altered mental status (GCS score<15) considering baseline clinical characteristics, CSF cytokines/chemokines, and antiretroviral therapy. Among 326 enrolled participants, 97 (30%) had GCS<15 and these patients had lower median CSF cryptococcal antigen titers (P = .042) and CCL2 (P = .005) but higher opening pressures (320 vs...
March 1, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28326747/laboratory-methods-for-diagnostics-of-hiv-infection-and-hiv-associated-neuroinfections
#20
Pavol Beno, Alzbeta Kaiglova, Martin Samohyl
HIV Infection resulting in AIDS remains serious global public health problem. In the fight with the global health problem plays a key role a simple, reliable and fast diagnostics. An important method in diagnostics is the identification and detection of viral capside p24 antigen levels. Fourth generation tests for the diagnostics of HIV infection simultaneously detect the presence of HIV antibodies and p24 antigen. Based on the monitoring of CD4 count, we can estimate the stage in which the infection is, and we can also suggest a therapeutic approach...
January 2017: Neuro Endocrinology Letters
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