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cryptococcus meningitis

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
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
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
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
Tinashe Kenny Nyazika, Ferry Hagen, Tendai Machiridza, Melody Kutepa, Faith Masanganise, Marijke Hendrickx, Teun Boekhout, Tricia Magombei-Majinjiwa, Nonthokozo Siziba, Nyasha Chin'ombe, Kudzanai Mateveke, Jacques Meis, Valerie Jean Robertson
HIV and cryptococcal meningitis coinfection are 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 C...
September 13, 2016: Journal of Medical Microbiology
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)...
September 15, 2016: Mycoses
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
Ya Liu, Mei Kang, Si-Ying Wu, Ying Ma, Zhi-Xing Chen, Yi Xie, Jiang-Tao Tang
Cryptococcus is the major pathogen that causes fungal meningitis. In the People's Republic of China, especially in the Southwest area, cryptococcal meningitis (CM) in HIV-uninfected patients is more common than in HIV-infected patients. We compared clinical features and laboratory data pertaining to CM in patients with different immunological statuses. Demographic data, clinical manifestations, and laboratory data from inpatients in West China Hospital Sichuan University were collected from June 2009 to June 2014...
September 8, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Tinashe K Nyazika, Patricia F Herkert, Ferry Hagen, Kudzanai Mateveke, Valerie J Robertson, Jacques F Meis
Cryptococcus neoformans is the leading cause of cryptococcosis in HIV-infected subjects worldwide. Treatment of cryptococcosis is based on amphotericin B, flucytosine, and fluconazole. In Zimbabwe, little is known about antifungal susceptibility of Cryptococcus. Sixty-eight genotyped Cryptococcus isolates were tested for antifungal profiles. Amphotericin B, isavuconazole, and voriconazole showed higher activity than other triazoles. Fluconazole and flucytosine were less effective, with geometric mean MICs of 2...
November 2016: Diagnostic Microbiology and Infectious Disease
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)
Tallulah Spina-Tensini, Marisol Dominguez Muro, Flávio Queiroz-Telles, Isabella Strozzi, Samia Talise Moraes, Ricardo Rasmussen Petterle, Marcelo Vettorello, Claudia Staudacher, Luiz Alberto Lopes Miguez, Sérgio Monteiro de Almeida
Cryptococcal meningitis is mainly caused by members of the C. neoformans/C. gattii species complexes. The ecological niches of Cryptococcus species have extensively been studied, but its epidemiological relationship with meningitis cases is still unknown. In this study, we estimate the relationship between cryptococcal meningitis cases and tree and pigeon populations, the classical niches of members of C. neoformans/C. gattii sensu lato. We analysed the records of every patient whose cerebrospinal fluid culture yielded Cryptococcus spp...
August 26, 2016: Mycoses
Stephen K Kyei, Henry Ogbomo, ShuShun Li, Martina Timm-McCann, Richard F Xiang, Shaunna M Huston, Anutosh Ganguly, Pina Colarusso, M John Gill, Christopher H Mody
UNLABELLED: Cryptococcus neoformans is a pathogenic yeast and a leading cause of life-threatening meningitis in AIDS patients. Natural killer (NK) cells are important immune effector cells that directly recognize and kill C. neoformans via a perforin-dependent cytotoxic mechanism. We previously showed that NK cells from HIV-infected patients have aberrant anticryptococcal killing and that interleukin-12 (IL-12) restores the activity at least partially through restoration of NKp30. However, the mechanisms causing this defect or how IL-12 restores the function was unknown...
2016: MBio
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
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
Baozhu Wei, Cheng Qian, Yang Liu, Xuan Lin, Jing Wan, Yanggan Wang
The objective is to study the role of Ommaya reservoir in the treatment of cryptococcal meningitis. The clinical data of 42 patients with cryptococcal meningitis were retrospectively studied. The Ommaya group included 20 patients, who were treated with Amphotericin B (Am B) and Ommaya reservoir implantation. The non-Ommaya group contained 22 patients, who were just treated with Amphotericin B (Am B). In the Ommaya group (surgical group), all 20 patients with Ommaya reservoir were fully recovered, and their average hospital stay period and average treatment period with Amphotericin B were 105...
August 4, 2016: Acta Neurologica Belgica
Yoon-Dong Park, Wei Sun, Antonio Salas, Avan Antia, Cindy Carvajal, Amy Wang, Xin Xu, Zhaojin Meng, Ming Zhou, Gregory J Tawa, Jean Dehdashti, Wei Zheng, Christina M Henderson, Adrian M Zelazny, Peter R Williamson
UNLABELLED: Cryptococcus neoformans is a pathogenic fungus that is responsible for up to half a million cases of meningitis globally, especially in immunocompromised individuals. Common fungistatic drugs, such as fluconazole, are less toxic for patients but have low efficacy for initial therapy of the disease. Effective therapy against the disease is provided by the fungicidal drug amphotericin B; however, due to its high toxicity and the difficulty in administering its intravenous formulation, it is imperative to find new therapies targeting the fungus...
2016: MBio
Fulgence K Kassi, Pascal Drakulovski, Virginie Bellet, Donika Krasteva, François Gatchitch, Adama Doumbia, Gisèle A Kouakou, Eric Delaporte, Jacques Reynes, Michèle Mallié, Hervé I E Menan, Sebastien Bertout
Cryptococcal meningitis is a severe opportunistic infection in HIV-infected patients. In Ivory Coast, despite the availability of antiretroviral treatment (ART), this infection is still prevalent. The study investigates the genetic diversity of 363 clinical isolates of Cryptococcus from 61 Ivorian HIV-positive patients, the occurrence of mixed infections and the in vitro antifungal susceptibility of the isolates. Serotyping was performed via LAC1 and CAP64 gene amplification. Genotyping was performed using the phage M13 core (GACA)4 and (GTG)5 primers and restriction fragment length polymorphism analysis of the URA5 gene...
July 27, 2016: Mycoses
Jun Li, Peipei Wang, Ling Ye, Yanfang Wang, Xiuzhen Zhang, Songping Yu
Although cryptococcal meningitis (CM) typically occurs in immunocompromised hosts, immunocompetent humans are susceptible to CM. In humans with an intact immune system, CM presents with signs and symptoms typical of meningitis, including fever, headache and neck stiffness. The present study reported the case of a female immunocompetent patient who presented visual blurring in both eyes and bilateral papilledema for ~1 month. Following hospital admission, the patient was diagnosed with optic nerve inflammation and was treated with intravenous methylprednisolone and oral prednisone...
August 2016: Experimental and Therapeutic Medicine
B Simsek, E Guven, R Gumral, G Mert, M A Saracli, B Besirbellioglu, S T Yildiran
Cryptococcal meningitis is considered rare in immunocompetent patients and is mainly a disease of immunocompromised patients. We report a case of cryptococcal meningitis, due to Cryptococcus neoformans, in an apparently healthy individual with abnormal levels of isolated immunological markers. Regardless of the patient's immune status, the result of the disease can be serious unless the disease is diagnosed early.
September 2016: Journal de Mycologie Médicale
Zhe Xu, Yafei Zhi, Jianzhang Dong, Benfeng Lin, Di Ye, Xiaoguang Liu
Cryptococcus neoformans is a major cause of fungal meningitis in individuals with impaired immunity. Our previous studies have shown that the VPS41 gene plays a critical role in the survival of Cryptococcus neoformans under nitrogen starvation; however, the molecular mechanisms underlying VPS41-mediated starvation response remain to be elucidated. In the present study, we show that, under nitrogen starvation, VPS41 strongly enhanced ICL1 expression in C. neoformans and that overexpression of ICL1 in the vps41 mutant dramatically suppressed its defects in starvation response due to the loss of VPS41 function...
July 2016: Journal of Microbiology / the Microbiological Society of Korea
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