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https://www.readbyqxmd.com/read/27906037/integrated-therapy-for-hiv-and-cryptococcosis
#1
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
#2
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...
November 25, 2016: 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
#3
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/27853088/disseminated-cryptococcosis-in-a-63-year-old-patient-with-multiple-sclerosis-treated-with-fingolimod
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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...
August 26, 2016: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/27558179/csf-1-3-beta-d-glucan-testing-is-useful-in-diagnosis-of-coccidioidal-meningitis
#15
David A Stevens, Yonglong Zhang, Malcolm A Finkelman, Pappagianis Demosthenes, Karl V Clemons, Martinez Marife
Diagnosing coccidioidal meningitis (CM) can be problematic owing to infrequency and/or delay of positivity of CSF culture or CSF antibody, particularly if primary coccidioidal infection is unrecognized. We tested 37 CSF specimens, 26 from confirmed CM and 11 from patients with suspected microbial meningitis without fungal diagnosis, for (1, 3)-beta glucan (BG). CM CSF specimens BG ranged from 18-3300 pg/ml, controls <3.9-103. Diagnostic performance was determined using 31 pg/ml cutoff (bottom of serum range per directions for commercial kit, though further serial dilutions of the standard indicated linearity to 3...
August 24, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27527636/point-of-care-testing-for-cryptococcal-disease-among-hospitalized-human-immunodeficiency-virus-infected-adults-in-ethiopia
#16
Admasu Tenna Mamuye, Ethan Bornstein, Obsie Temesgen, Henry M Blumberg, Russell R Kempker
In a cross-sectional study among hospitalized human immunodeficiency virus (HIV)-infected patients in Ethiopia, we sought to determine the rates and predictors of cryptococcal disease and evaluate the test performance of a recently introduced point-of-care test for Cryptococcus neoformans detection in various biological samples. We tested serum, urine, and fingerstick blood samples from each patient with a cryptococcal antigen lateral flow assay (CRAG LFA; Immuno Mycologic Inc., Norman, OK). Cerebrospinal fluid was collected at the discretion of the treating physician...
October 5, 2016: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/27525140/diagnostic-challenges-of-cryptococcus-neoformans-in-an-immunocompetent-individual-masquerading-as-chronic-hydrocephalus
#17
Kedar R Mahajan, Amity L Roberts, Mark T Curtis, Danielle Fortuna, Robin Dharia, Lori Sheehan
Cryptococcus neoformans can cause disseminated meningoencephalitis and evade immunosurveillance with expression of a major virulence factor, the polysaccharide capsule. Direct diagnostic assays often rely on the presence of the cryptococcal glucuronoxylomannan capsular antigen (CrAg) or visualization of the capsule. Strain specific phenotypic traits and environmental conditions influence differences in expression that can thereby compromise detection and timely diagnosis. Immunocompetent hosts may manifest clinical signs and symptoms indolently, often expanding the differential and delaying appropriate treatment and diagnosis...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27502502/risk-factors-for-cryptococcal-meningitis-a-single-united-states-center-experience
#18
Andrés F Henao-Martínez, Lilyana Gross, Bryan Mcnair, Bruce McCollister, Kristen DeSanto, Jose G Montoya, Leland Shapiro, J David Beckham
Cryptococcal meningitis carries a high mortality. Further understanding of immune suppression factors associated with neuroinvasive infection will improve risk stratification and enhance early diagnosis and treatment with antifungal therapy. The aim of the study was to corroborate established or find novel clinical predictors for cryptococcal meningitis. We performed a matched case-control study of Cryptococcus infection in immunocompromised patients with or without cryptococcal meningitis. Data of all patients with a diagnosis of cryptococcal disease were collected at University of Colorado Hospital between 2000 and 2015 (n = 51)...
August 8, 2016: Mycopathologia
https://www.readbyqxmd.com/read/27419153/retrospective-study-of-cryptococcal-meningitis-with-elevated-minimum-inhibitory-concentration-to-fluconazole-in-immunocompromised-patients
#19
Hashem Nasri, Sarah Kabbani, Melhim Bou Alwan, Yun F Wang, Paulina A Rebolledo, Colleen S Kraft, Minh L Nguyen, Albert M Anderson, Nadine Rouphael
Background.  Mortality for cryptococcal meningitis remains significant, in spite of available treatment. Resistance to first-line maintenance therapy, particularly fluconazole, has been reported. Methods.  A retrospective chart review was performed on immunocompromised patients with cryptococcal meningitis, who had susceptibility testing performed between January 2001 and December 2011, at 3 hospitals in Atlanta, Georgia. Results.  A total of 35 immunocompromised patients with cryptococcal meningitis were identified, 13 (37...
April 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27358661/point-of-care-testing-for-the-diagnosis-of-fungal-infections-are-we-there-yet
#20
Juergen Prattes, Sven Heldt, Susanne Eigl, Martin Hoenigl
Diagnostic tools for invasive fungal infections have continuously improved within the last decades. Nowadays, cultural methods, antigen testing, and molecular tests, such as polymerase chain reaction, are widely used. These methods, however, are accompanied with different limitations as various availability, various turnaround time or high costs. A new generation of point-of-care test has shown promising results in various studies and may overcome some of these limitations. We therefore reviewed the literature for the most promising new point-of-care tests for invasive aspergillosis (Aspergillus-specific lateral-flow device test, Aspergillus proximity ligation antigen assay), cryptococcosis (cryptococcal lateral-flow assay), and for histoplasmosis (loop-mediated isothermal amplification assay)...
2016: Current Fungal Infection Reports
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