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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/29214004/prevalence-of-cryptococcal-antigen-positivity-among-hiv-infected-patient-with-cd4-cell-count-less-than-100-of-imam-khomeini-hospital-tehran-iran
#2
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/29184017/vaccination-with-recombinant-cryptococcus-proteins-in-glucan-particles-protects-mice-against-cryptococcosis-in-a-manner-dependent-upon-mouse-strain-and-cryptococcal-species
#3
Charles A Specht, Chrono K Lee, Haibin Huang, Maureen M Hester, Jianhua Liu, Bridget A Luckie, Melanie A Torres Santana, Zeynep Mirza, Payam Khoshkenar, Ambily Abraham, Zu T Shen, Jennifer K Lodge, Ali Akalin, Jane Homan, Gary R Ostroff, Stuart M Levitz
Development of a vaccine to protect against cryptococcosis is a priority given the enormous global burden of disease in at-risk individuals. Using glucan particles (GPs) as a delivery system, we previously demonstrated that mice vaccinated with crude Cryptococcus-derived alkaline extracts were protected against lethal challenge with Cryptococcus neoformans and Cryptococcus gattii The goal of the present study was to identify protective protein antigens that could be used in a subunit vaccine. Using biased and unbiased approaches, six candidate antigens (Cda1, Cda2, Cda3, Fpd1, MP88, and Sod1) were selected, recombinantly expressed in Escherichia coli, purified, and loaded into GPs...
November 28, 2017: MBio
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
#4
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/29104281/incidental-finding-of-cryptococcus-on-prostate-biopsy-for-prostate-adenocarcinoma-following-cardiac-transplant-case-report-and-review-of-the-literature
#5
Sujal I Shah, Hai Bui, Nelson Velasco, Shilpa Rungta
BACKGROUND Cryptococcus is the third most common invasive fungal organism in immunocompromised patients, including transplant patients, and usually involves the central nervous system and lungs, with a median time to infection of 25 months. We report a case of Cryptococcus of the prostate gland, found as an incidental finding on prostate biopsy for prostate adenocarcinoma, four months following cardiac transplantation. CASE REPORT A 62-year-old male African-American who had a cardiac transplant four months previously, underwent a six-core prostate biopsy for a two-year history of increasing prostate-specific antigen (PSA) levels, and a recent history of non-specific urinary tract symptoms...
November 6, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29069886/liquid-based-cytology-of-the-cerebrospinal-fluid-in-a-case-of-cryptococcal-meningitis
#6
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/29036605/survey-of-laboratory-practices-for-diagnosis-of-fungal-infection-in-seven-asian-countries-an-asia-fungal-working-group-afwg-initiative
#7
Ariya Chindamporn, Arunaloke Chakrabarti, Ruoyu Li, Pei-Lun Sun, Ban-Hock Tan, Mitzi Chua, Retno Wahyuningsih, Atul Patel, Zhengyin Liu, Yee-Chun Chen, Methee Chayakulkeeree
An online survey of mycology laboratories in seven Asian countries was conducted to assess the status, competence, and services available. Country representatives from the Asia Fungal Working Group (AFWG) contacted as many laboratories performing mycology diagnosis as possible in their respective countries, requesting that the laboratory heads complete the online survey. In total, 241 laboratories responded, including 71 in China, 104 in India, 11 in Indonesia, 26 in the Philippines, four in Singapore, 18 in Taiwan, and seven in Thailand...
September 20, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/29033946/exploitation-of-scavenger-receptor-macrophage-receptor-with-collagenous-structure-by-cryptococcus-neoformans-promotes-alternative-activation-of-pulmonary-lymph-node-cd11b-conventional-dendritic-cells-and-non-protective-th2-bias
#8
Jintao Xu, Adam Flaczyk, Lori M Neal, Zhenzong Fa, Daphne Cheng, Mike Ivey, Bethany B Moore, Jeffrey L Curtis, John J Osterholzer, Michal A Olszewski
Macrophage receptor with collagenous structure (MARCO) contributes to fungal containment during the early/innate phase of cryptococcal infection; however, its role in adaptive antifungal immunity remains unknown. Using a murine model of cryptococcosis, we compared host adaptive immune responses in wild-type and MARCO(-/-) mice throughout an extended time course post-infection. Unlike in early infection, MARCO deficiency resulted in improved pulmonary fungal clearance and diminished cryptococcal dissemination during the efferent phase...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29028998/high-cryptococcal-antigen-titers-in-blood-are-predictive-of-subclinical-cryptococcal-meningitis-among-hiv-infected-patients
#9
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/29020172/high-dose-fluconazole-monotherapy-is-inadequate-for-csf-cryptococcal-antigen-positive-hiv-infected-persons-in-an-ethiopian-crag-screening-program
#10
Tafese Beyene, Anteneh G Zewde, Abera Balcha, Belda Hirpo, Tadele Yitbarik, Teshome Gebissa, Radha Rajasingham, David R Boulware
817 HIV-infected Ethiopians with CD4 <=150/mcL underwent lab-based reflex cryptococcal antigen(CrAg) screening, using remaining plasma after CD4 testing. Of participants with plasma CrAg titers >=1:640, 96% (27/28) had cryptococcal meningitis (CSF CrAg+). When treated with fluconazole 1200mg monotherapy, 68% (23/34) of CSF CrAg+ died within three months.
July 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28959388/a-rare-presentation-of-cryptococcal-meningoencephalitis-in-an-immunocompetent-individual
#11
Ashwin Malhotra, Qin Rao, Sean Kelly, Danielle Schwartz, Robert Chow
Cryptococcal meningoencephalitis is a leading of morbidity and mortality in immunocompromised individuals worldwide. However, there are few documented cases in immunocompetent patients. We present a rare case of disseminated Cryptococcus with progression to meningoencephalitis in an immunocompetent patient, with a possible atypical presentation. Magnetic resonance imaging of the brain and electroencephalogram to rule out brain metastasis were negative. Lumbar puncture resulted positive for Cryptococcus neoformans antigen at titers of 1:2048 and a detailed history later revealed occupational exposure to bird dander by cleaning floors and cages...
September 15, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28877182/cryptococcal-antigen-screening-by-lay-cadres-using-a-rapid-test-at-the-point-of-care-a-feasibility-study-in-rural-lesotho
#12
Fernanda Rick, Aline Aurore Niyibizi, Amir Shroufi, Kazumi Onami, Sarah-Jane Steele, Malehlohonolo Kuleile, Innocent Muleya, Tom Chiller, Tiffany Walker, Gilles Van Cutsem
INTRODUCTION: Cryptococcal meningitis is one of the leading causes of death among people with HIV in Africa, primarily due to delayed presentation, poor availability and high cost of treatment. Routine cryptococcal antigen (CrAg) screening of patients with a CD4 count less than 100 cells/mm3, followed by pre-emptive therapy if positive, might reduce mortality in high prevalence settings. Using the cryptococcal antigen (CrAg) lateral flow assay (LFA), screening is possible at the point of care (POC)...
2017: PloS One
https://www.readbyqxmd.com/read/28830348/evaluation-of-trypan-blue-stain-in-a-haemocytometer-for-rapid-detection-of-cerebrospinal-fluid-sterility-in-hiv-patients-with-cryptococcal-meningitis
#13
Richard Kwizera, Andrew Akampurira, Tadeo K Kandole, Kirsten Nielsen, Andrew Kambugu, David B Meya, David R Boulware, Joshua Rhein
BACKGROUND: Quantitative culture is the most common method to determine the fungal burden and sterility of cerebrospinal fluid (CSF) among persons with cryptococcal meningitis. A major drawback of cultures is a long turnaround-time. Recent evidence demonstrates that live and dead Cryptococcus yeasts can be distinguished using trypan blue staining. We hypothesized that trypan blue staining combined with haemocytometer counting may provide a rapid estimation of quantitative culture count and detection of CSF sterility...
August 22, 2017: BMC Microbiology
https://www.readbyqxmd.com/read/28829788/estimating-the-cost-per-result-of-a-national-reflexed-cryptococcal-antigenaemia-screening-program-forecasting-the-impact-of-potential-hiv-guideline-changes-and-treatment-goals
#14
Naseem Cassim, Lindi Marie Coetzee, Kathryn Schnippel, Deborah Kim Glencross
INTRODUCTION: During 2016, the National Health Laboratory Service (NHLS) introduced laboratory-based reflexed Cryptococcal antigen (CrAg) screening to detect early Cryptococcal disease in immunosuppressed HIV+ patients with a confirmed CD4 count of 100 cells/μl or less. OBJECTIVE: The aim of this study was to assess cost-per-result of a national screening program across different tiers of laboratory service, with variable daily CrAg test volumes. The impact of potential ART treatment guideline and treatment target changes on CrAg volumes, platform choice and laboratory workflow are considered...
2017: PloS One
https://www.readbyqxmd.com/read/28806629/aseptic-meningitis-in-adults-and-children-diagnostic-and-management-challenges
#15
Bhavarth Shukla, Elizabeth A Aguilera, Lucrecia Salazar, Susan H Wootton, Quanhathai Kaewpoowat, Rodrigo Hasbun
BACKGROUND: Aseptic meningitis represents a common diagnostic and management dilemma to clinicians. OBJECTIVES: To compare the clinical epidemiology, diagnostic evaluations, management, and outcomes between adults and children with aseptic meningitis. STUDY DESIGN: We conducted a retrospective study from January 2005 through September 2010 at 9 Memorial Hermann Hospitals in Houston, TX. Patients age≥2months who presented with community-acquired aseptic meningitis with a CSF white blood cell count >5cells/mm(3) and a negative Gram stain and cultures were enrolled...
September 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28776195/clinical-characteristics-and-prognosis-of-pediatric-cryptococcosis-in-beijing-children-s-hospital-2002-2014
#16
Linlin Liu, Lingyun Guo, Yue Liu, Tianming Chen, Shaoying Li, Yonghong Yang, Gang Liu
Cryptococcosis is a rare pediatric disease. The aim of the study is to describe clinical characteristics and prognosis of pediatric cryptococcosis from 2002 to 2014 in Beijing Children's Hospital. A total of 53 cases of cryptococcosis were identified, 69.8% of which were males. The mean age was 7 years. Forty-one (77.4%) patients had no underlying conditions. Fever, headache, and vomiting were the most common symptoms. The most common sites were the central nervous system (CNS), followed by the lungs. Most patients received a combination of amphotericin B and fluconazole with or without flucytosine as their initial regimen...
September 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28750078/acridine-orange-fluorescent-microscopy-is-more-sensitive-than-india-ink-light-microscopy-in-the-rapid-detection-of-cryptococcosis-among-crag-positive-hiv-patients
#17
Richard Kwizera, Andrew Akampurira, Darlisha Williams, David R Boulware, David B Meya
BACKGROUND: India ink microscopy on cerebrospinal fluid is still utilized in resource limited settings for the diagnosis of cryptococcal meningitis despite its poor sensitivity. We hypothesized that staining fungal nucleic acids with fluorescent dyes instead of the capsule with India ink might improve sensitivity for the diagnosis of cryptococcal meningitis. METHODS: We enrolled 96 HIV-infected participants with cryptococcal meningitis who provided 194 CSF specimens at serial time points in Kampala, Uganda...
2017: PloS One
https://www.readbyqxmd.com/read/28747366/cross-reacting-ustilago-maydis-causing-false-positive-cryptococcal-antigen-test-results
#18
LETTER
Matthew P Cheng, Tien T Nguyen, Leighanne O Parkes, Philippe J Dufresne, Donald C Sheppard
No abstract text is available yet for this article.
October 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28673256/cryptococcosis-in-patients-with-hematological-diseases-a-14-year-retrospective-clinical-analysis-in-a-chinese-tertiary-hospital
#19
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/28667348/cryptococcosis-in-hiv-negative-patients-with-renal-dialysis-a-retrospective-analysis-of-pooled-cases
#20
Nan Hong, Min Chen, Wenjie Fang, Abdullah M S Al-Hatmi, Teun Boekhout, Jianping Xu, Lei Zhang, Jia Liu, Weihua Pan, Wanqing Liao
Cryptococcosis is a lethal fungal infection mainly caused by Cryptococcus neoformans/C. gattii species. Currently, our understanding of cryptococcosis episodes in HIV-negative patients during renal dialysis remains scarce and fragmented. Here, we performed an analysis of pooled cases to systemically summarize the epidemiology and clinical characteristics of cryptococcosis among HIV-negative patients with renal dialysis. Using pooled data from our hospital and studies identified in four medical databases, 18 cases were identified and analyzed...
June 30, 2017: Mycopathologia
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