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https://www.readbyqxmd.com/read/28217607/concurrent-central-nervous-system-infective-pathology-in-a-severely-immunocompromised-patient
#1
Thein Swe, Bordes P Laurent, Nickul N Shah
To our knowledge and literature search, concurrent cryptococcal meningitis and neurosyphilis in a patient have rarely been reported. Here, we report a 37-year-old male with HIV infection presented with headache and dizziness for 5 days along with memory difficulty and personality changes for about 1 week. During the hospital stay, cryptococcal meningitis was confirmed with positive cerebral spinal fluid (CSF) cryptococcal antigen titer (1:320) and positive CSF culture. Diagnosis of neurosyphilis was made based upon CSF white blood cell count of 85 cells/μL, with CSF total protein of 87 mg/dL, reactive CSF treponemal antibody, and fluorescent treponemal antibody...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28166254/establishing-a-cost-per-result-of-laboratory-based-reflex-cryptococcal-antigenaemia-screening-crag-in-hiv-patients-with-cd4-counts-less-than-100-cells-%C3%AE-l-using-a-lateral-flow-assay-lfa-at-a-typical-busy-cd4-laboratory-in-south-africa
#2
Naseem Cassim, Kathryn Schnippel, Lindi Marie Coetzee, Deborah Kim Glencross
INTRODUCTION: Cryptococcal meningitis is a major cause of mortality and morbidity in countries with high HIV prevalence, primarily affecting patients whose CD4 are < = 100 cells/μl. Routine Cryptococcal Antigen (CrAg) screening is thus recommended in the South African HIV treatment guidelines for all patients with CD4 counts < = 100 cells/μl, followed by pre-emptive anti-fungal therapy where CrAg results are positive. A laboratory-based reflexed CrAg screening approach, using a Lateral Flow Assay (LFA) on remnant EDTA CD4 blood samples, was piloted at three CD4 laboratories...
2017: PloS One
https://www.readbyqxmd.com/read/28134711/looking-for-fungi-in-all-the-right-places-screening-for-cryptococcal-disease-and-other-aids-related-mycoses-among-patients-with-advanced-hiv-disease
#3
Greg Greene, Charlotte Sriruttan, Thuy Le, Tom Chiller, Nelesh P Govender
PURPOSE OF REVIEW: As HIV treatment programmes scale up to meet the UNAIDS 90-90-90 goals, care must be taken to start antiretroviral treatment safely in patients with advanced disease (CD4 counts <200 cells/μl) who are simultaneously at risk for opportunistic infections and immune reconstitution inflammatory syndrome. Invasive fungal diseases pose a great threat at this critical time point, though the development of inexpensive and highly accurate rapid diagnostic tests has changed the approach HIV programmes are taking to reduce the high mortality associated with these opportunistic infections...
March 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28133852/atypical-cutaneous-cryptococcosis-in-four-cats-in-the-usa
#4
Alexandra Myers, Courtney Meason-Smith, Joanne Mansell, Mark Krockenberger, Jeanine Peters-Kennedy, Harold Ross Payne, Aline Rodrigues Hoffmann
BACKGROUND: Cryptococcosis is an uncommon fungal infection in humans and mammals. Occasionally, cryptococcosis manifests as cutaneous lesions, either as an extension of nasal disease or as stand alone lesions unassociated with the nose. Histologically, these lesions are typically characterized by abundant organisms with mild granulomatous dermatitis. Herein, four feline cases of atypical cutaneous cryptococcal infections are described. METHODS: Skin punch biopsies from four client owned cats were submitted for histological evaluation between 2006 and 2015...
January 29, 2017: Veterinary Dermatology
https://www.readbyqxmd.com/read/28101016/cellulitis-in-a-liver-transplant-patient-as-an-initial-manifestation-of-disseminated-cryptococcal-disease
#5
Marcos Davi Gomes de Sousa, Fred Bernardes Filho, Luís Eduardo Barros Costa Fernandes, Cássia Regina Guedes Leal, Cristiane Rocha Magalhães, Marcos Antonio Custódio Neto da Silva, Halime Silva Barcaui
A 50-year-old male underwent liver transplantation due to cryptogenic cirrhosis and was admitted with severe pain in the left leg as well as phlogosis. Amoxicillin/clavulanic acid was prescribed, assuming bullous erysipelas. Among the tests performed, the latex agglutination test for the Cryptococcus sp. antigen was positive, and in both the blood culture and blister culture Cryptococcus sp. was isolated. Daily fluconazole was started. Even though liposomal amphotericin B has been started on the fifth day of hospitalization, the patient progressed to death...
September 2016: Case Reports in Dermatology
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
#6
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
#7
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
#8
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
#9
Ian Gassiep, David McDougall, Joel Douglas, Ross Francis, Elliott G Playford
BACKGROUND: The aim of this research paper was 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/27853088/disseminated-cryptococcosis-in-a-63-year-old-patient-with-multiple-sclerosis-treated-with-fingolimod
#10
Hiroyuki Seto, Mitsushige Nishimura, Katsuhiro Minamiji, Sonoko Miyoshi, Hiroyuki Mori, Kenji Kanazawa, Hisafumi Yasuda
We herein report the case of a 63-year-old man who presented with a 3-month history of a cutaneous nodular lesion of his jaw, low grade fever, lethargy and progressive cognitive impairment. He had a 30-year history of multiple sclerosis and had been treated with fingolimod for the previous 2 years. Laboratory data revealed CD4 lymphocytopenia and a tissue culture of the skin nodule was positive for Cryptococcus neoformans. Cerebrospinal fluid and serum cryptococcal antigen tests were also positive and we diagnosed him to have disseminated cryptococcosis...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27814690/characteristics-and-outcomes-of-cryptococcal-meningitis-in-hiv-seronegative-children-in-beijing-china-2002-2013
#11
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/27766797/clinical-diversity-of-cns-cryptococcosis
#12
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 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27760140/estimated-prevalence-of-cryptococcus-antigenemia-crag-among-hiv-infected-adults-with-advanced-immunosuppression-in-namibia-justifies-routine-screening-and-preemptive-treatment
#13
Souleymane Sawadogo, Boniface Makumbi, Anne Purfield, Christophine Ndjavera, Gram Mutandi, Andrew Maher, Francina Kaindjee-Tjituka, Jonathan E Kaplan, Benjamin J Park, David W Lowrance
BACKGROUND: Cryptococcal meningitis is common and associated with high mortality among HIV infected persons. The World Health Organization recommends that routine Cryptococcal antigen (CrAg) screening in ART-naïve adults with a CD4+ count <100 cells/μL followed by pre-emptive antifungal therapy for CrAg-positive patients be considered where CrAg prevalence is ≥3%. The prevalence of CrAg among HIV adults in Namibia is unknown. We estimated CrAg prevalence among HIV-infected adults receiving care in Namibia for the purpose of informing routine screening strategies...
2016: PloS One
https://www.readbyqxmd.com/read/27742281/cryptococcosis-in-renal-transplant-recipients-a-single-center-experience
#14
S Marques, R Carmo, I Ferreira, M Bustorff, S Sampaio, M Pestana
BACKGROUND: In solid organ transplant patients, 8% of invasive fungal infections are attributed to Cryptococcus. The aim of this study was to determine the frequency, risk factors, clinical characteristics, and outcome of kidney transplant recipients (TR) infected with Cryptococcus. CASE SERIES: Between 2007 and 2014, a total of 500 kidney transplantations were performed at São João Hospital, in Porto, Portugal. Six infections by C. neoformans were reported, an incidence of 1...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27704021/pulmonary-cryptococcosis-in-the-immunocompetent-patient-many-questions-some-answers
#15
John F Fisher, Paula A Valencia-Rey, William B Davis
Background.  There are no prospective data regarding the management of pulmonary cryptococcosis in the immunocompetent patient. Clinical guidelines recommend oral fluconazole for patients with mild to moderate symptoms and amphotericin B plus flucytosine followed by fluconazole for severe disease. It is unclear whether patients who have histological evidence of Cryptococcus neoformans but negative cultures will even respond to drug treatment. We evaluated and managed a patient whose presentation and course raised important questions regarding the significance of negative cultures, antifungal choices, duration of therapy, and resolution of clinical, serologic, and radiographic findings...
September 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27699970/asymptomatic-cryptococcal-antigen-prevalence-detected-by-lateral-flow-assay-in-hospitalised-hiv-infected-patients-in-s%C3%A3-o-paulo-brazil
#16
José E Vidal, Carolina Toniolo, Adriana Paulino, Arnaldo Colombo, Marilena Dos Anjos Martins, Cristina da Silva Meira, Vera Lucia Pereira-Chioccola, Claudia Figueiredo-Mello, Tiago Barros, Jequelie Duarte, Fernanda Fonseca, Mirella Alves Cunha, Clara Mendes, Taiana Ribero, Marcia Dos Santos Lazera, Radha Rajasingham, David R Boulware
OBJECTIVE: To determine the prevalence of asymptomatic cryptococcal antigen (CRAG) using lateral flow assay (LFA) in hospitalised HIV-infected patients with CD4 counts <200 cells/μl. METHODS: Hospitalised HIV-infected patients were prospectively recruited at Instituto de Infectologia Emilio Ribas, a tertiary referral hospital to HIV-infected patients serving the São Paulo State, Brazil. All patients were >18 years old without prior cryptococcal meningitis, without clinical suspicion of cryptococcal meningitis, regardless of antiretroviral (ART) status, and with CD4 counts <200 cells/μl...
December 2016: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/27601609/unique-characteristics-of-cryptococcosis-identified-after-death-in-patients-with-liver-cirrhosis-comparison-with-concurrent-cohort-diagnosed-antemortem
#17
Nina Singh, Costi D Sifri, Fernanda P Silveira, Rachel Miller, Kevin S Gregg, Shirish Huprikar, Erika D Lease, Andrea Zimmer, J Stephen Dummer, Cedric W Spak, Christine Koval, David B Banach, Miloni Shroff, Jade Le, Darin Ostrander, Robin Avery, Albert Eid, Raymund R Razonable, Jose Montero, Emily Blumberg, Ahlaam Alynbiawi, Michele I Morris, Henry B Randall, George Alangaden, Jeffrey Tessier, Thomas V Cacciarelli, Marilyn M Wagener, Hsin Yun Sun
Characteristics of cirrhosis-associated cryptococcosis first diagnosed after death are not fully known. In a multicenter study, data generated as standard of care was systematically collected in 113 consecutive patients with cirrhosis and cryptococcosis followed for 80 patient-years. The diagnosis of cryptococcosis was first established after death in 15.9% (18/113) of the patients. Compared to cases diagnosed while alive, these patients had higher MELD score (33 vs. 22, P = .029) and higher rate of cryptococcemia (75...
September 6, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/27583871/cryptococcal-meningitis-complicating-sarcoidosis
#18
REVIEW
Sonja E Leonhard, Daan Fritz, Diederik van de Beek, Matthijs C Brouwer
BACKGROUND: Cryptococcal meningitis is an uncommon but severe complication of sarcoidosis. METHODS: We present 2 patients with cryptococcal meningitis complicating sarcoidosis and compared findings with 38 cases reported in the literature. RESULTS: When analyzing our patients and 38 cases reported in the literature, we found that median age of sarcoidosis patients with cryptococcal meningitis was 39 years (range 30-48); 27 of 33 reported cases (82%) had a history of sarcoidosis...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27581773/localized-cutaneous-cryptococcosis-summary-of-reported-cases-in-japan
#19
Hiromitsu Noguchi, Masataro Hiruma, Keishi Maruo, Masayoshi Jono, Keishi Miyata, Hideaki Tanaka, Koichi Tanabe, Yoshitsugu Miyazaki, Hironobu Ihn
A 68-year-old male plasterer with no history of trauma presented to our clinic in March 2012 with a 16×14-mm ulcer that developed following a crushed small papule on the right anterior chest. In April 2012, the patient was referred to another hospital, where cutaneous cryptococcosis was diagnosed based on discharge culture results. The patient was treated with oral itraconazole at a dose of 150 mg/day for 10 weeks; however, the ulcer remained unchanged and he discontinued the treatment. In May 2014, when he revisited our clinic, the ulcer with crust had grown to 29×13 mm...
2016: Medical Mycology Journal
https://www.readbyqxmd.com/read/27566775/immune-reconstitution-inflammatory-syndrome-associated-with-secondary-syphilis
#20
Simona Frunza-Stefan, Gyanendra Acharya, Viktoryia Kazlouskaya, Paunel Vukasinov, Yushan Chiou, Zeyar Thet
Immune reconstitution inflammatory syndrome (IRIS) is a condition associated with paradoxical worsening and/or new onset of an opportunistic infection in HIV patients following the initiation of anti-retroviral therapy or switching to more potent antiretroviral therapy (ART) regimen. Although IRIS associated with many opportunistic infections (OIs) has been well reported, syphilis has very rarely been mentioned in this regard. A 52-year-old male, diagnosed with AIDS six weeks ago, presented with the disseminated non-pruritic painless skin rash...
March 2017: International Journal of STD & AIDS
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