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cryptococcus meningitis

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https://www.readbyqxmd.com/read/29028998/high-cryptococcal-antigen-titers-in-blood-are-predictive-of-subclinical-cryptococcal-meningitis-among-hiv-infected-patients
#1
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/29021643/cryptococcal-cerebellitis-in-no-vih-patient
#2
Fabricio Andres Lasso, Tomas Omar Zamora Bastidas, Jorge Andrés Potosí García, Bairon Díaz Idrobo
INTRODUCTION: Cryptococcosis is an opportunistic fungal infection whose etiology is Cryptococcus neofromans / C. gattii, complex which affects immunocompromised patients mainly. Meningeal infection is one of the most common presentations, but cerebellar affection is rare. CASE DESCRIPTION: Male patient with 65 old years, from an area of subtropical climate with chronic exposure to poultry, without pathological antecedents, who presented clinical picture consistent with headache, fever, seizures and altered mental status...
June 30, 2017: Colombia Médica: CM
https://www.readbyqxmd.com/read/28992308/relationship-between-intracranial-pressure-and-antifungal-agents-levels-in-the-csf-of-patients-with-cryptococcal-meningitis
#3
Fernanda Wirth, Maria Isabel de Azevedo, Carmen Pilla, Valério Rodrigues Aquino, Gustavo Wissmann Neto, Luciano Zubaran Goldani
The purpose of this study was to evaluate the influence of intracranial hypertension in the cerebrospinal fluid (CSF) levels of amphotericin B and fluconazole levels of patients with cryptococcal meningitis. CSF samples and intracranial pressure were obtained by means of routine punctures performed at days 1, 7, and 14 of therapy, respectively. Amphotericin B and fluconazole CSF levels were measured by HPLC method as previously described. The minimum inhibitory concentration for amphotericin B, fluconazole, 5΄flucytosine, and voriconazole of each Cryptococcus isolate was performed according to CLSI...
August 2, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/28934415/first-report-of-urease-activity-in-the-novel-systemic-fungal-pathogen-emergomyces-africanus-a-comparison-with-the-neurotrope-cryptococcus-neoformans
#4
Barbra Lerm, Chris Kenyon, Ilan S Schwartz, Heinrich Kroukamp, Riaan de Witt, Nelesh P Govender, G Sybren de Hoog, Alfred Botha
Cryptococcus neoformans is an opportunistic pathogen responsible for the AIDS-defining illness, cryptococcal meningitis. During the disease process, entry of cryptococcal cells into the brain is facilitated by virulence factors that include urease enzyme activity. A novel species of an Emmonsia-like fungus, recently named Emergomyces africanus, was identified as a cause of disseminated mycosis in HIV-infected persons in South Africa. However, in contrast to C. neoformans, the enzymes produced by this fungus, some of which may be involved in pathogenesis, have not been described...
November 1, 2017: FEMS Yeast Research
https://www.readbyqxmd.com/read/28928997/neurosyphilis-with-concomitant-cryptococcal-and-tuberculous-meningitis-in-a-patient-with-aids-report-of-a-unique-case
#5
Jose Armando Gonzales Zamora, Luis Alberto Espinoza, Rita N Nwanyanwu
Meningitis in individuals living with acquired immunodeficiency syndrome (AIDS) is most frequently infectious in origin and usually due to opportunistic infections. The most common pathogens are Cryptococcus neoformans and Mycobacterium tuberculosis. Treponema pallidum causes neurosyphilis and can complicate HIV infections at any time after the initial infection. Simultaneous infections of the central nervous system caused by these pathogens are very uncommon even in the setting of severe immunosuppression...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28857298/cryptococcosis-in-patients-with-diabetes-mellitus-ii-in-mainland-china-1993-2015
#6
Yingfang Li, Wenjie Fang, Weiwei Jiang, Ferry Hagen, Jia Liu, Lei Zhang, Nan Hong, Yu Zhu, Xiaoguang Xu, Xia Lei, Danqi Deng, Jianping Xu, Wanqing Liao, Teun Boekhout, Min Chen, Weihua Pan
Diabetes mellitus II (DM II) is a newly defined independent factor contributing to the morbidity and mortality of cryptococcosis. This retrospective case analysis aims to explore the epidemiology, clinical profile and strain characteristics of cryptococcosis in Chinese DM II patients. This study included 30 cases of cryptococcosis with DM II occurring from 1993 to 2015 in mainland China. The hospital-based prevalence of cryptococcosis in DM II was 0.21%. The mean age of the patients was 56.1 years (95% confidence interval: 51...
August 30, 2017: Mycoses
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
#7
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/28793019/cryptococcus-neoformans-and-c-gattii-isolates-from-both-hiv-infected-and-uninfected-patients-antifungal-susceptibility-and-outcome-of-cryptococcal-disease
#8
Erika Nascimento, Lucia Helena Vitali, Marcia Regina von Zeska Kress, Roberto Martinez
One of the factors causing treatment failure in cryptococcosis is the resistance of Cryptococcus spp. to antifungal drugs, which has motivated the susceptibility assessment of isolates from patients with cryptococcosis, different clinical conditions and infections outcomes. Clinical isolates of Cryptococcus spp. from three different groups of patients were studied in the present investigation: 19 HIV-positive patients with relapsing and/or refractory meningitis (Group 1), 30 HIV-positive patients who experienced a single and limited episode of cryptococcosis (Group 2), and 19 HIV-negative patients with cryptococcosis (Group 3)...
2017: Revista do Instituto de Medicina Tropical de São Paulo
https://www.readbyqxmd.com/read/28775082/disseminated-cryptococcal-infection-in-a-patient-who-had-kidney-transplant-discrepancy-between-clinical-symptoms-and-microbiological-findings
#9
Suzan Dahdal, Robert Kalicki, Niklaus Von Steiger, Parham Sendi
A 29-year-old man complained of a 2-day history of frontal headache and new-onset fever but no other symptoms. Two months prior to admission, he underwent his third kidney transplantation. Clinical and laboratory examinations were unremarkable. Brain MRI showed a meningeal irritation consistent with viral meningitis. A diagnosis of cryptococcal meningitis and fungaemia was made after detection of a remarkably high and visible load of Cryptococcus neoformans in the cerebrospinal fluid.
August 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28752102/acute-kidney-injury-and-urinary-biomarkers-in-human-immunodeficiency-virus-associated-cryptococcal-meningitis
#10
Charlotte Schutz, David R Boulware, Katherine Huppler-Hullsiek, Maximilian von Hohenberg, Joshua Rhein, Kabanda Taseera, Friedrich Thienemann, Conrad Muzoora, David B Meya, Graeme Meintjes
BACKGROUND: Cryptococcus is the most common etiology of adult meningitis in Africa. Amphotericin B deoxycholate remains paramount to treatment, despite toxicities, including acute kidney injury (AKI). We assessed the ability of the following urine markers to predict AKI in patients who received amphotericin B: urine neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (CysC), tissue inhibitor of metalloproteinases-2 (TIMP-2), and protein. METHODS: One hundred and thirty human immunodeficiency virus (HIV)-infected participants with cryptococcal meningitis were enrolled and received amphotericin and fluconazole for 2 weeks...
2017: Open Forum Infectious Diseases
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
#11
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/28736880/central-nervous-system-infection-due-to-cryptococcus-gattii-sensu-lato-in-india-analysis-of-clinical-features-molecular-profile-and-antifungal-susceptibility
#12
Shayanki Lahiri Mukhopadhyay, Veenakumari H Bahubali, Netravathi Manjunath, Aarthi Swaminathan, Sayani Maji, Marimuthu Palaniappan, Satishchandra Parthasarathy, Nagarathna Chandrashekar
Cryptococcus gattii species complex has evolved as a pathogen in the last two decades causing infection among both immunocompetent and immunocompromised hosts. We aimed to analyse the clinical features of CNS infection caused by C. gattii sensu lato, molecular and antifungal susceptibility profile of this pathogen. Cases diagnosed to have CNS cryptococcosis were included in the study. Cryptococcus recovered from patient's specimen was identified by standard protocol. Species confirmation, mating type and molecular type determination were performed by PCR based methods...
July 23, 2017: Mycoses
https://www.readbyqxmd.com/read/28700464/cryptococcal-meningitis-after-transnasal-transsphenoidal-pituitary-microsurgery-of-acth-secreting-pituitary-adenoma-a-case-report
#13
Yang Liu, Ming Feng, Yong Yao, Kan Deng, Xinjie Bao, Xiaohai Liu, Renzhi Wang
RATIONALE: Microbial infection should be regarded in the differential diagnosis of neurosurgical complications after transnasal transsphenoidal pituitary microsurgery, albeit cryptococcal meningitis is rare. This article will discuss the risk factors of cryptococcal meningitis in patients underwent transnasal transsphenoidal pituitary microsurgery, and summary the potential origins of infection. PATIENT CONCERNS AND DIAGNOSIS: Here, we report a case of 37-year-old male who had cryptococcal meningitis after transnasal transsphenoidal pituitary microsurgery of a relapsing ACTH-secreting pituitary adenoma...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28679543/tracing-genetic-exchange-and-biogeography-of-cryptococcus-neoformans-var-grubii-at-the-global-population-level
#14
Johanna Rhodes, Christopher A Desjardins, Sean M Sykes, Mathew A Beale, Mathieu Vanhove, Sharadha Sakthikumar, Yuan Chen, Sharvari Gujja, Sakina Saif, Anuradha Chowdhary, Daniel John Lawson, Vinicius Ponzio, Arnaldo Lopes Colombo, Wieland Meyer, David M Engelthaler, Ferry Hagen, Maria Teresa Illnait-Zaragozi, Alexandre Alanio, Jo-Marie Vreulink, Joseph Heitman, John R Perfect, Anastasia P Litvintseva, Tihana Bicanic, Thomas S Harrison, Matthew C Fisher, Christina A Cuomo
Cryptococcus neoformans var. grubii is the causative agent of cryptococcal meningitis, a significant source of mortality in immunocompromised individuals, typically human immunodeficiency virus/AIDS patients from developing countries. Despite the worldwide emergence of this ubiquitous infection, little is known about the global molecular epidemiology of this fungal pathogen. Here we sequence the genomes of 188 diverse isolates and characterize the major subdivisions, their relative diversity, and the level of genetic exchange between them...
September 2017: Genetics
https://www.readbyqxmd.com/read/28631642/sporadic-occurrence-of-cryptococcal-meningitis-in-hiv-seronegative-patients-uncommon-etiology
#15
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/28630940/fluconazole-induced-ploidy-change-in-cryptococcus-neoformans-results-from-the-uncoupling-of-cell-growth-and-nuclear-division
#16
Sophie Altamirano, Diana Fang, Charles Simmons, Shreyas Sridhar, Peipei Wu, Kaustuv Sanyal, Lukasz Kozubowski
Cryptococcus neoformans is a pathogenic yeast that causes lethal cryptococcal meningitis in immunocompromised patients. One of the challenges in treating cryptococcosis is the development of resistance to azole antifungals. Previous studies linked azole resistance to elevated numbers of copies of critical resistance genes in aneuploid cells. However, how aneuploidy is formed in the presence of azole drugs remains unclear. This study showed that treatment with inhibitory concentrations of an azole drug, fluconazole (FLC), resulted in a significant population of cells with increased DNA content, through the following defects: inhibition of budding, premature mitosis, and inhibition of cytokinesis followed by replication in the mother cell...
May 2017: MSphere
https://www.readbyqxmd.com/read/28622118/imaging-spectrum-of-invasive-fungal-and-fungal-like-infections
#17
Hilary L P Orlowski, Sebastian McWilliams, Vincent M Mellnick, Sanjeev Bhalla, Meghan G Lubner, Perry J Pickhardt, Christine O Menias
Invasive fungal and fungal-like infections contribute to substantial morbidity and mortality in immunocompromised individuals. The incidence of these infections is increasing-largely because of rising numbers of immunocompromised patients, including those with neutropenia, human immunodeficiency virus, chronic immunosuppression, indwelling prostheses, burns, and diabetes mellitus, and those taking broad-spectrum antibiotics. Invasive fungal pathogens include primary mycotic organisms such as Histoplasma capsulatum, Coccidioides immitis, Blastomyces dermatitidis, and Paracoccidioides brasiliensis, which are true pathogens and inherently virulent...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28614360/comparative-genomics-of-cryptococcus-neoformans-var-grubii-associated-with-meningitis-in-hiv-infected-and-uninfected-patients-in-vietnam
#18
COMPARATIVE STUDY
Jeremy N Day, Seet Qihui, Lam Tuan Thanh, Phan Hai Trieu, Anh Duong Van, Nha Hoang Thu, Tran Thi Hong Chau, Nguyen P H Lan, Nguyen Van Vinh Chau, Philip M Ashton, Guy E Thwaites, Maciej F Boni, Marcel Wolbers, Niranjan Nagarajan, Patrick B O Tan, Stephen Baker
The vast burden of cryptococcal meningitis occurs in immunosuppressed patients, driven by HIV, and is caused by Cryptococcus neoformans var. grubii. We previously reported cryptococcal meningitis in Vietnam arising atypically in HIV uninfected, apparently immunocompetent patients, caused by a single amplified fragment length polymorphism (AFLP) cluster of C. neoformans var. grubii (VNIγ). This variant was less common in HIV infected individuals; it remains unclear why this lineage is associated with apparently immunocompetent patients...
June 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28584857/evolving-failures-in-the-delivery-of-human-immunodeficiency-virus-care-lessons-from-a-ugandan-meningitis-cohort-2006-2016
#19
Andrew G Flynn, David B Meya, Katherine Huppler Hullsiek, Joshua Rhein, Darlisha A Williams, Abdu Musubire, Bozena M Morawski, Kabanda Taseera, Alisat Sadiq, Liberica Ndyatunga, Mollie Roediger, Radha Rajasingham, Paul R Bohjanen, Conrad Muzoora, David R Boulware
BACKGROUND: Because of investments in human immunodeficiency virus (HIV) care in sub-Saharan Africa, the number of people aware of their status and receiving antiretroviral therapy (ART) has increased; however, HIV/acquired immune deficiency syndrome (AIDS) mortality still remains high. METHODS: We performed retrospective analysis of 3 sequential prospective cohorts of HIV-infected Ugandan adults presenting with AIDS and meningitis from 2006 to 2009, 2010 to 2012, and 2013 to 2016...
2017: Open Forum Infectious Diseases
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
#20
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
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