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cryptococcus meningitis

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https://www.readbyqxmd.com/read/28188180/a-population-genomics-approach-to-assessing-the-genetic-basis-of-within-host-microevolution-underlying-recurrent-cryptococcal-meningitis-infection
#1
Johanna Rhodes, Mathew A Beale, Mathieu Vanhove, Joseph N Jarvis, Shichina Kannambath, John A Simpson, Anthea Ryan, Graeme Meintjes, Thomas S Harrison, Matthew C Fisher, Tihana Bicanic
Recurrence of meningitis due to Cryptococcus neoformans after treatment causes substantial mortality in HIV/AIDS patients across sub-Saharan Africa. In order to determine whether recurrence occurred due to relapse of the original infecting isolate or reinfection with a different isolate weeks or months after initial treatment, we used whole-genome sequencing to assess the genetic basis of infection in 17 HIV-infected individuals with recurrent cryptococcal meningitis. Comparisons revealed a clonal relationship for 15 pairs of isolates recovered before and after recurrence showing relapse of the original infection...
February 10, 2017: G3: Genes—Genomes—Genetics
https://www.readbyqxmd.com/read/28188169/cerebral-cryptococcoma-mimicking-glioblastoma
#2
Kimberly B Ulett, James W J Cockburn, Rosalind Jeffree, Marion L Woods
Cryptococcus neoformans and C. gattii cause invasive fungal disease, with meningitis being the most common manifestation of central nervous system (CNS) disease. Encapsulated cryptococcomas occur rarely, predominantly in immunocompetent hosts, usually related to C. gattii Our patient was an immunocompetent man who presented with headache and a large cystic CNS lesion thought to be glioblastoma. Biopsy of a concomitant lung lesion confirmed cryptococcoma and empiric antifungal therapy was started for presumed CNS cryptococcoma...
February 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28144629/pho4-is-essential-for-dissemination-of-cryptococcus-neoformans-to-the-host-brain-by-promoting-phosphate-uptake-and-growth-at-alkaline-ph
#3
Sophie Lev, Keren Kaufman-Francis, Desmarini Desmarini, Pierre G Juillard, Cecilia Li, Sebastian A Stifter, Carl G Feng, Tania C Sorrell, Georges E R Grau, Yong-Sun Bahn, Julianne T Djordjevic
Phosphate acquisition by fungi is regulated by the phosphate-sensing and acquisition (PHO) signaling pathway. Cryptococcus neoformans disseminates from the lung to the brain and is the commonest cause of fungal meningitis worldwide. To investigate the contribution of PHO signaling to cryptococcal dissemination, we characterized a transcription factor knockout strain (hlh3Δ/pho4Δ) defective in phosphate acquisition. Despite little similarity with other fungal Pho4 proteins, Hlh3/Pho4 functioned like a typical phosphate-responsive transcription factor in phosphate-deprived cryptococci, accumulating in nuclei and triggering expression of genes involved in phosphate acquisition...
January 2017: MSphere
https://www.readbyqxmd.com/read/28099434/mlst-based-population-genetic-analysis-in-a-global-context-reveals-clonality-amongst-cryptococcus-neoformans-var-grubii-vni-isolates-from-hiv-patients-in-southeastern-brazil
#4
Kennio Ferreira-Paim, Leonardo Andrade-Silva, Fernanda M Fonseca, Thatiana B Ferreira, Delio J Mora, Juliana Andrade-Silva, Aziza Khan, Aiken Dao, Eduardo C Reis, Margarete T G Almeida, Andre Maltos, Virmondes R Junior, Luciana Trilles, Volker Rickerts, Ariya Chindamporn, Jane E Sykes, Massimo Cogliati, Kirsten Nielsen, Teun Boekhout, Matthew Fisher, June Kwon-Chung, David M Engelthaler, Marcia Lazéra, Wieland Meyer, Mario L Silva-Vergara
Cryptococcosis is an important fungal infection in immunocompromised individuals, especially those infected with HIV. In Brazil, despite the free availability of antiretroviral therapy (ART) in the public health system, the mortality rate due to Cryptococcus neoformans meningitis is still high. To obtain a more detailed picture of the population genetic structure of this species in southeast Brazil, we studied 108 clinical isolates from 101 patients and 35 environmental isolates. Among the patients, 59% had a fatal outcome mainly in HIV-positive male patients...
January 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28052943/corticosteroid-induced-cryptococcal-meningitis-in-patient-without-hiv
#5
Anand Nidhi, Alpana Meena, Arjun Sreekumar, Mradul Kumar Daga
Cryptococcus neoformans is the most frequent cause of fungal meningitis in humans. Cryptococcus affects people of all ages and has a worldwide distribution. It is the fourth most common infection in AIDS (CD4 counts <100/mm(3)). Cases also occur in patients with other forms of immunosuppression and in apparently immunocompetent individuals. Chronic high-dose steroid may precipitate such an immunocompromised state and thus create susceptibility to fungal infections. In our case, we describe a 14-year-old boy who was on steroids for tubercular meningitis for a period of 8 weeks after which he developed cryptococcal meningitis...
January 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28031206/physiological-differences-in-cryptococcus-neoformans-strains-in-vitro-versus-in-vivo-and-their-effects-on-antifungal-susceptibility
#6
REVIEW
Nina T Grossman, Arturo Casadevall
Cryptococcus neoformans is an environmentally ubiquitous fungal pathogen that primarily causes disease in people with compromised immune systems, particularly those with advanced AIDS. There are estimated to be almost 1 million cases per year of cryptococcal meningitis in patients infected with human immunodeficiency virus, leading to over 600,000 annual deaths, with a particular burden in sub-Saharan Africa. Amphotericin B (AMB) and fluconazole (FLC) are key components of cryptococcal meningitis treatment: AMB is used for induction, and FLC is for consolidation, maintenance and, for occasional individuals, prophylaxis...
March 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28018689/cryptococcus-gattii-in-an-immunocompetent-patient-in-the-southeastern-united-states
#7
John W Amburgy, Joseph H Miller, Benjamin J Ditty, Patrick Vande Lune, Shaaf Muhammad, Winfield S Fisher
Cryptococcal infections are seen throughout the United States in both immunocompromised and immunocompetent patients. The most common form is C. neoformans. In the Northwestern United States, C. gattii has received considerable attention secondary to increased virulence resulting in significant morbidity and mortality. There are no cases in the extant literature describing a patient with C. gattii requiring neurosurgical intervention in Alabama. A middle-aged immunocompetent male with no recent travel or identifiable exposure presented with meningitis secondary to C...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27918582/investigating-conservation-of-the-cell-cycle-regulated-transcriptional-program-in-the-fungal-pathogen-cryptococcus-neoformans
#8
Christina M Kelliher, Adam R Leman, Crystal S Sierra, Steven B Haase
The pathogenic yeast Cryptococcus neoformans causes fungal meningitis in immune-compromised patients. Cell proliferation in the budding yeast form is required for C. neoformans to infect human hosts, and virulence factors such as capsule formation and melanin production are affected by cell-cycle perturbation. Thus, understanding cell-cycle regulation is critical for a full understanding of virulence factors for disease. Our group and others have demonstrated that a large fraction of genes in Saccharomyces cerevisiae is expressed periodically during the cell cycle, and that proper regulation of this transcriptional program is important for proper cell division...
December 2016: PLoS Genetics
https://www.readbyqxmd.com/read/27906037/integrated-therapy-for-hiv-and-cryptococcosis
#9
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/27866167/rewiring-of-signaling-networks-modulating-thermotolerance-in-the-human-pathogen-cryptococcus-neoformans
#10
Dong-Hoon Yang, Kwang-Woo Jung, Soohyun Bang, Jang-Won Lee, Min-Hee Song, Anna Floyd-Averette, Richard A Festa, Giuseppe Ianiri, Alexander Idnurm, Dennis J Thiele, Joseph Heitman, Yong-Sun Bahn
Thermotolerance is a crucial virulence attribute for human pathogens, including the fungus Cryptococcus neoformans that causes fatal meningitis in humans. Loss of the protein kinase Sch9 increases C. neoformans thermotolerance, but its regulatory mechanism has remained unknown. Here, we studied the Sch9-dependent and Sch9-independent signaling networks modulating C. neoformans thermotolerance by using genome-wide transcriptome analysis and reverse genetic approaches. During temperature upshift, genes encoding for molecular chaperones and heat shock proteins were upregulated, whereas those for translation, transcription, and sterol biosynthesis were highly suppressed...
January 2017: Genetics
https://www.readbyqxmd.com/read/27862555/genomic-epidemiology-of-cryptococcus-yeasts-identifies-adaptation-to-environmental-niches-underpinning-infection-across-an-african-hiv-aids-cohort
#11
Mathieu Vanhove, Mathew A Beale, Johanna Rhodes, Duncan Chanda, Shabir Lakhi, Geoffrey Kwenda, Sile Molloy, Natasha Karunaharan, Neil Stone, Thomas S Harrison, Tihana Bicanic, Matthew C Fisher
Emerging infections caused by fungi have become a widely recognized global phenomenon and are causing an increasing burden of disease. Genomic techniques are providing new insights into the structure of fungal populations, revealing hitherto undescribed fine-scale adaptations to environments and hosts that govern their emergence as infections. Cryptococcal meningitis is a neglected tropical disease that is responsible for a large proportion of AIDS-related deaths across Africa; however, the ecological determinants that underlie a patient's risk of infection remain largely unexplored...
October 19, 2016: Molecular Ecology
https://www.readbyqxmd.com/read/27852678/disseminated-cryptococcosis-in-an-immunocompetent-child
#12
Noora Saeed, Hena A Ansari, Nazoora Khan, Mohsin Aijaz
Cryptococcus is a ubiquitous fungus and is known for causing meningitis and cutaneous infections in immunocompromised individuals. Disseminated cryptococcal infection is very rare and almost always found to occur in immunocompromised individuals especially in persons infected with HIV. This is particularly attributed to its capsulated spores. But there are few reported cases in which it has been found to cause disseminated infections even in immunocompetent individuals. We report a similar case of disseminated cryptococcal infection in an immunocompetent host...
November 16, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27818191/corticosteroids-for-the-management-of-severe-intracranial-hypertension-in-meningoencephalitis-caused-by-cryptococcus-gattii-a-case-report-and-review
#13
R-A Maciel, L-S Ferreira, F Wirth, P-D Rosa, M Aves, E Turra, L-Z Goldani
Immune reconstitution inflammatory syndrome in meningitis caused by Cryptococcus gattii in immunocompetent patients after initiation of antifungal therapy appears to be the result of paradoxical antifungal treatment-induced clinical deterioration due to improved local immune responses to cryptococcal organisms. Recent anecdotal reports have suggested a favorable clinical response to corticosteroids in select patients with C. gattii central nervous system (CNS) infections. In this report, we describe a 65-year-old patient with meningoencephalitis caused by C...
November 3, 2016: Journal de Mycologie Médicale
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
#14
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
#15
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/27664991/activity-of-vt-1129-against-cryptococcus-neoformans-clinical-isolates-with-high-fluconazole-mics
#16
Kirsten Nielsen, Priya Vedula, Kyle D Smith, David B Meya, Edward P Garvey, William J Hoekstra, Robert J Schotzinger, David R Boulware
Although antifungal drug resistance in the human fungal pathogen Cryptococcus neoformans is relatively uncommon, fluconazole-resistant strains are problematic for preemptive treatment of cryptococcal antigenemia or during cryptococcal meningitis consolidation therapy. We analyzed activity of the experimental antifungal VT-1129 on 51 clinical Cryptococcus neoformans isolates previously screened for fluconazole resistance; with an emphasis on fluconazole dose-dependent (MIC 16-32 μg/ml) or resistant (MIC ≥ 64 μg/ml) isolates...
September 24, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/27651801/pattern-clinical-characteristics-and-outcome-of-meningitis-among-hiv-infected-adults-admitted-in-a-tertiary-hospital-in-north-western-tanzania-a-cross-sectional-study
#17
Matobogolo M Boaz, Samuel Kalluvya, Jennifer A Downs, Bonaventura C T Mpondo, Stephen E Mshana
Background. Limited information exists on the etiologies, clinical characteristics, and outcomes of meningitis among HIV-infected patients in Africa. We conducted a study to determine the etiology, clinical characteristics, and outcomes of meningitis among HIV-infected adults. Methods. A prospective cross-sectional hospital based study was conducted among HIV-infected patients aged ≥18 years admitted to the medical wards with symptoms and signs of meningitis. Sociodemographic and clinical information were collected using a standardized data collection tool...
2016: Journal of Tropical Medicine
https://www.readbyqxmd.com/read/27638836/cryptococcus-neoformans-population-diversity-and-clinical-outcomes-of-hiv-associated-cryptococcal-meningitis-patients-in-zimbabwe
#18
Tinashe K Nyazika, Ferry Hagen, Tendai Machiridza, Melody Kutepa, Faith Masanganise, Marijke Hendrickx, Teun Boekhout, Tricia Magombei-Majinjiwa, Nonthokozo Siziba, Nyasha Chin'ombe, Kudzanai Mateveke, Jacques F Meis, Valerie J Robertson
HIV and cryptococcal meningitis co-infection is a major public health problem in most developing countries. Cryptococcus neoformans sensu stricto is responsible for the majority of HIV-associated cryptococcosis cases in sub-Saharan Africa. Despite the available information, little is known about cryptococcal population diversity and its association with clinical outcomes in patients with HIV-associated cryptococcal meningitis in sub-Saharan Africa. In a prospective cohort, we investigated the prevalence and clinical outcome of Cryptococcusneoformans sensu stricto meningitis among HIV-infected patients in Harare, Zimbabwe, and compared the genotypic diversity of the isolates with those collected from other parts of Africa...
November 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27633849/molecular-identification-antifungal-resistance-and-virulence-of-cryptococcus-neoformans-and-cryptococcus-deneoformans-isolated-in-seville-spain
#19
Sara Gago, Carmen Serrano, Ana Alastruey-Izquierdo, Isabel Cuesta, Estrella Martín-Mazuelos, Ana Isabel Aller, Alicia Gómez-López, Emilia Mellado
Cryptococcal meningitis is one of the leading causes of death in HIV/AIDS patients. Our aim was to in order to characterise the epidemiology, antifungal susceptibility pattern and virulence of 28 Cyptococcus sp. strains recovered from 12 AIDS patients during two years in a Spanish single institution. Antifungal susceptibility testing was performed according to the CLSI protocols. Clinical strains were molecularly characterised by serotyping, mating type, PCR fingerprinting (M13 and GACA4 microsatellites) and analysis of two rDNA regions (IGS1 and ITS)...
January 2017: Mycoses
https://www.readbyqxmd.com/read/27629591/unique-roles-of-the-unfolded-protein-response-pathway-in-fungal-development-and-differentiation
#20
Kwang-Woo Jung, Yee-Seul So, Yong-Sun Bahn
Cryptococcus neoformans, a global fungal meningitis pathogen, employs the unfolded protein response pathway. This pathway, which consists of an evolutionarily conserved Ire1 kinase/endoribonuclease and a unique transcription factor (Hxl1), modulates the endoplasmic reticulum stress response and pathogenicity. Here, we report that the unfolded protein response pathway governs sexual and unisexual differentiation of C. neoformans in an Ire1-dependent but Hxl1-independent manner. The ire1∆ mutants showed defects in sexual mating, with reduced cell fusion and pheromone-mediated formation of the conjugation tube...
2016: Scientific Reports
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