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https://www.readbyqxmd.com/read/29663539/cryptococcal-infections-over-a-15-year-period-at-a-tertiary-facility-impact-of-guideline-management
#1
Ian Gassiep, Joel Douglas, Theophilus I Emeto, Katherine Crawley, Elliott G Playford
BACKGROUND: Cryptococcosis is an invasive fungal infection caused primarily by Cryptococcus neoformans and Cryptococcus gattii species, presenting predominantly as meningoencephalitis. The aim of this study is to assess all cryptococcal infections managed at our facility from 2001-2015 to determine incidence, risk factors, and comparison of outcomes prior to and following introduction of the 2010 Infectious Disease Society of America (IDSA) guidelines. METHODS: Retrospective analysis of all patients diagnosed and treated for cryptococcal infection occurring between January 2001 and December 2015...
April 17, 2018: Mycoses
https://www.readbyqxmd.com/read/29630156/ulcerative-cellulitis-of-the-arm-a-case-of-primary-cutaneous-cryptococcosis
#2
G P Henderson, Sean Dreyer
Cutaneous cryptococcosis is usually secondary to the hematogenous dissemination of pulmonary or meningeal Cryptococcus neoformans. Primary cutaneous cryptococcosis (PCC) is a rare form of the infection, typically caused by direct inoculation from trauma to the skin [1]. Most cases of PCC present as a localized cellulitis, abscess, nodule, or ulceration. Herein, we present a case of a rapidly spreading cellulitis characterized by bullae and ulceration, caused by direct inoculation from a fall.
February 15, 2018: Dermatology Online Journal
https://www.readbyqxmd.com/read/29619316/pulmonary-cryptococcal-infection-presenting-with-multiple-lung-nodules
#3
Thilini L Basnayake, Aijye Lim, Bart J Currie
Pulmonary infections from the environmental fungus Cryptococcus gattii ( C. gattii ) are notable for cryptococcomas, which are usually solitary and can be very large. As with infections with Cryptococcus neoformans (C. neoformans) patients can have concomitant cryptococcal meningitis; however, unlike for C. neoformans, infections with C. gattii often occur in immunocompetent patients. The highest published incidence of C. gattii infection has been in the Indigenous Australian population of Arnhem Land in the tropical north of the country...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29596441/quantifying-donor-to-donor-variation-in-macrophage-responses-to-the-human-fungal-pathogen-cryptococcus-neoformans
#4
Mariam Garelnabi, Leanne M Taylor-Smith, Ewa Bielska, Rebecca A Hall, Daniel Stones, Robin C May
Cryptococcosis remains the leading cause of fungal meningitis worldwide, caused primarily by the pathogen Cryptococcus neoformans. Symptomatic cryptococcal infections typically affect immunocompromised patients. However, environmental exposure to cryptococcal spores is ubiquitous and most healthy individuals are thought to harbor infections from early childhood onwards that are either resolved, or become latent. Since macrophages are a key host cell for cryptococcal infection, we sought to quantify the extent of individual variation in this early phagocyte response within a small cohort of healthy volunteers with no reported immunocompromising conditions...
2018: PloS One
https://www.readbyqxmd.com/read/29593675/cryptococcal-antigen-screening-in-asymptomatic-hiv-infected-antiretroviral-na%C3%A3-ve-patients-in-cameroon-and-evaluation-of-the-new-semi-quantitative-biosynex-cryptops-test
#5
Elvis Temfack, Charles Kouanfack, Leonella Mossiang, Angela Loyse, Marie C Fonkoua, Síle F Molloy, Sinata Koulla-Shiro, Eric Delaporte, Françoise Dromer, Thomas Harrison, Olivier Lortholary
Background: Cryptococcal meningitis (CM) is a major cause of AIDS-related mortality in Africa. Detection of serum cryptococcal antigen (CrAg) predicts development of CM in antiretroviral (ART) naïve HIV-infected patients with severe immune depression. Systematic pre-ART CrAg screening and pre-emptive oral fluconazole is thus recommended. We postulated that a semi-quantitative CrAg screening approach could offer clinically relevant advantages. Methods: ART-naïve asymptomatic adult outpatients with <100 CD4 cells/mm3 presenting to the Yaoundé Central Hospital, Cameroon were screened for CrAg using the IMMY lateral flow assay (LFA)...
2018: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29583086/dual-infection-of-the-central-nervous-system-caused-by-cryptococcus-and-toxoplasma-in-a-patient-with-aids-a-case-report-and-literature-review
#6
Jose Armando Gonzales Zamora
Dual infection of the central nervous system secondary to Cryptococcus and Toxoplasma is very uncommon, even in the setting of acquired immunodeficiency syndrome (AIDS). We report the case of a 52-year-old patient who was admitted with multiple cranial nerve deficits. Magnetic resonance imaging showed supratentorial and infratentorial enhancing lesions. He was newly diagnosed with HIV infection with a CD4 count of 59 cells/uL and HIV viral load of 299,619 copies/mL. Diagnosis of Cryptococcus meningitis was made by Cryptococcal antigen in cerebrospinal fluid (CSF)...
March 27, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29513784/advances-in-cryptococcus-genomics-insights-into-the-evolution-of-pathogenesis
#7
Christina A Cuomo, Johanna Rhodes, Christopher A Desjardins
Cryptococcus species are the causative agents of cryptococcal meningitis, a significant source of mortality in immunocompromised individuals. Initial work on the molecular epidemiology of this fungal pathogen utilized genotyping approaches to describe the genetic diversity and biogeography of two species, Cryptococcus neoformans and Cryptococcus gattii. Whole genome sequencing of representatives of both species resulted in reference assemblies enabling a wide array of downstream studies and genomic resources...
2018: Memórias do Instituto Oswaldo Cruz
https://www.readbyqxmd.com/read/29509588/a-prospective-evaluation-of-a-multisite-cryptococcal-screening-and-treatment-program-in-hiv-clinics-in-uganda
#8
Elizabeth Nalintya, David B Meya, Sarah Lofgren, Kathy Huppler Hullsiek, David R Boulware, Radha Rajasingham
BACKGROUND: Cryptococcus is a leading cause of AIDS-related mortality. Cryptococcal antigen (CrAg) is detectable in blood before meningitis onset, and predicts death. CrAg screening amongst those with advanced HIV, and treatment of those CrAg+ with fluconazole has demonstrated survival benefit. However, implementation and widespread uptake have been slow outside of clinical trials. METHODS: We designed a CrAg screening program for routine care that incorporated intensive education and training of clinic staff...
March 2, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29466605/continuous-sheath-free-separation-of-drug-treated-human-fungal-pathogen-cryptococcus-neoformans-by-morphology-in-biocompatible-polymer-solutions
#9
Di Li, Jessica Zielinski, Lukasz Kozubowski, Xiangchun Xuan
Cryptococcal meningitis caused by Cryptococcus neoformans is the leading cause of fungal central nervous system infections. Current antifungal treatments for cryptococcal infections are inadequate partly due to the occurrence of drug resistance. Recent studies indicate that the treatment of the azole drug fluconazole changes the morphology of C. neoformans to form enlarged "multimeras" that consist of three or more connected cells/buds. To analyze if these multimeric cells are a prerequisite for C...
February 21, 2018: Electrophoresis
https://www.readbyqxmd.com/read/29463005/mechanisms-of-pulmonary-escape-and-dissemination-by-cryptococcus-neoformans
#10
REVIEW
Steven T Denham, Jessica C S Brown
Cryptococcus neoformans is a common environmental saprophyte and human fungal pathogen that primarily causes disease in immunocompromised individuals. Similar to many environmentally acquired human fungal pathogens, C. neoformans initiates infection in the lungs. However, the main driver of mortality is invasive cryptococcosis leading to fungal meningitis. After C. neoformans gains a foothold in the lungs, a critical early step in invasion is transversal of the respiratory epithelium. In this review, we summarize current knowledge relating to pulmonary escape...
February 17, 2018: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29456239/a-rare-presentation-of-cryptococcal-meningitis-and-cerebellitis-in-an-asplenic-patient-seronegative-for-human-immunodeficiency-virus-hiv
#11
Hafsa Abbas, Angelica CiFuentes Kottkamp, Naeem Abbas, Richard Cindrich, Manisha Singh
BACKGROUND Cryptococcal meningitis in patients who are seronegative for the human immunodeficiency virus (HIV) and in patients who are splenectomized is rare. This report is an unusual case of meningeal and cerebellar infection due to the encapsulated yeast, Cryptococcus neoformans, which has not previously been associated with asplenia. CASE REPORT A 65-year-old HIV-negative patient with a previous splenectomy, presented with a three-day history of fever, vomiting, and headache. His symptoms progressed to generalized body aches, persistent fever, and neck stiffness...
February 19, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29420767/evaluation-of-trypan-blue-stain-in-the-tc20-automated-cell-counter-as-a-point-of-care-for-the-enumeration-of-viable-cryptococcal-cells-in-cerebrospinal-fluid
#12
Richard Kwizera, Andrew Akampurira, Tadeo K Kandole, Maria S Nabaggala, Darlisha A Williams, Andrew Kambugu, David B Meya, Joshua Rhein, David R Boulware
Cerebrospinal fluid (CSF) culture can determine a quantitative viability of Cryptococcus yeasts; however, culture has a long turnaround-time. The TC20 automated cell counter (Bio-Rad) is a benchtop instrument used to count cells in 30 seconds. In vitro studies suggest trypan blue staining can distinguish between viable and dead cryptococcal yeasts. We hypothesized that trypan blue staining with automated cell counting may provide rapid quantification of viable CSF Cryptococcus yeasts. In sum, 96 HIV-infected participants with cryptococcal meningitis were enrolled and provided 194 CSF specimens in Kampala, Uganda...
October 9, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/29382737/udp-glucuronic-acid-transport-is-required-for-virulence-of-cryptococcus-neoformans
#13
Lucy X Li, Carsten Rautengarten, Joshua L Heazlewood, Tamara L Doering
Glycans play diverse biological roles, ranging from structural and regulatory functions to mediating cellular interactions. For pathogens, they are also often required for virulence and survival in the host. In Cryptococcus neoformans, an opportunistic pathogen of humans, the acidic monosaccharide glucuronic acid (GlcA) is a critical component of multiple essential glycoconjugates. One of these glycoconjugates is the polysaccharide capsule, a major virulence factor that enables this yeast to modulate the host immune response and resist antimicrobial defenses...
January 30, 2018: MBio
https://www.readbyqxmd.com/read/29377368/a-systematic-review-of-fluconazole-resistance-in-clinical-isolates-of-cryptococcus-species
#14
REVIEW
Felix Bongomin, Rita O Oladele, Sara Gago, Caroline B Moore, Malcolm D Richardson
Fluconazole is the most commonly used antifungal agent for both the treatment of cryptococcal meningitis, and for prophylaxis against the disease. However, its prolonged use has the potential to exert selection pressure in favour of fluconazole-resistant strains. We evaluated the prevalence of fluconazole resistance in Cryptococcus spp. clinical isolates in 29 studies from 1988 to May 2017 included in EMBASE and MEDLINE databases. A total of 4995 Cryptococcus isolates from 3210 patients constituted this study; 248 (5...
January 29, 2018: Mycoses
https://www.readbyqxmd.com/read/29374632/cryptococcal-meningitis-in-a-daily-cannabis-smoker-without-evidence-of-immunodeficiency
#15
Bryan B Shapiro, Rebecca Hedrick, Brigitte C Vanle, Courtney A Becker, Chris Nguyen, David M Underhill, Margie A Morgan, Joel D Kopple, Itai Danovitch, Waguih William IsHak
Cryptococcal meningitis is a life-threatening condition most commonly observed in immunocompromised individuals. We describe a daily cannabis smoker without evidence of immunodeficiency presenting with confirmed Cryptococcus neoformans meningitis. An investigation of cannabis samples from the patient's preferred dispensary demonstrated contamination with several varieties of Cryptococcus , including C. neoformans , and other opportunistic fungi. These findings raise concern regarding the safety of dispensary-grade cannabis, even in immunocompetent users...
January 26, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29373741/high-rates-of-cerebral-toxoplasmosis-in-hiv-patients-presenting-with-meningitis-in-accra-ghana
#16
Japheth A Opintan, Benedict K Awadzi, Isaac J K Biney, Vincent Ganu, Richard Doe, Ernest Kenu, Rita F Adu, Mary M Osei, Amos Akumwena, Michael E Grigg, Gary A Fahle, Mercy J Newman, Peter R Williamson, Margaret Lartey
Background: Data on adult meningitis among patients infected with the human immunodeficiency virus (HIV) is scarce in western sub-Saharan Africa, including Ghana. Methods: HIV-infected adults with a provisional diagnosis of meningitis were consecutively enrolled, between August 2014 and January 2016. After patient data collection, cerebrospinal fluid (CSF) was obtained and evaluated for microbiological aetiologies, cell counts and biochemistry. Caregiver clinicians provided limited data for inpatients at the end-point of discharge or death...
January 24, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29371497/neuro-immune-mechanisms-of-anti-cryptococcal-protection
#17
REVIEW
Rebecca A Drummond
Cryptococcal meningitis (CM) is a life-threatening fungal disease affecting both immunosuppressed and immunocompetent people. The main causative agent of CM is Cryptococcus neoformans, a basidiomycete fungus prevalent in the environment. Our understanding of the immune mechanisms controlling C. neoformans growth within the central nervous system (CNS) is poor. However, there have been several recent advances in the field of neuroimmunology regarding how cells resident within the CNS, such as microglia and neurons, can participate in immune surveillance and control of infection...
December 25, 2017: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29357302/role-of-the-inositol-pyrophosphate-multikinase-kcs1-in-cryptococcus-inositol-metabolism
#18
Guojian Liao, Yina Wang, Tong-Bao Liu, Gurkirat Kohli, Weidong Qian, Erika Shor, Selvakumar Subbian, Chaoyang Xue
Cryptococcus neoformans is the most common cause of deadly fungal meningitis. This fungus has a complex inositol acquisition and utilization system, and our previous studies have shown the importance of inositol utilization in cryptococcal development and virulence. However, how inositol utilization is regulated in this fungus remains unknown. In this study, we found that inositol, irrespective of the presence of glucose in the media, represses the expression of C. neoformans genes involved in inositol pyrophosphate biosynthesis, including the gene encoding inositol hexakisphosphate kinase Kcs1...
April 2018: Fungal Genetics and Biology: FG & B
https://www.readbyqxmd.com/read/29346417/xylose-donor-transport-is-critical-for-fungal-virulence
#19
Lucy X Li, Carsten Rautengarten, Joshua L Heazlewood, Tamara L Doering
Cryptococcus neoformans, an AIDS-defining opportunistic pathogen, is the leading cause of fungal meningitis worldwide and is responsible for hundreds of thousands of deaths annually. Cryptococcal glycans are required for fungal survival in the host and for pathogenesis. Most glycans are made in the secretory pathway, although the activated precursors for their synthesis, nucleotide sugars, are made primarily in the cytosol. Nucleotide sugar transporters are membrane proteins that solve this topological problem, by exchanging nucleotide sugars for the corresponding nucleoside phosphates...
January 2018: PLoS Pathogens
https://www.readbyqxmd.com/read/29327953/multicentric-cryptococcosis-in-a-congo-african-grey-parrot-psittacus-erithacus-erithacus
#20
Raina S K Schunk, Nicholas E Sitinas, Katherine E Quesenberry, Jessica L Grodio
An approximately 10-year-old, female Congo African grey parrot ( Psittacus erithacus erithacus) developed progressive, unilateral exophthalmos and buphthalmos. Survey radiographs revealed a large, coelomic, soft tissue mass, which was confirmed on computed tomography scan. Aspirates of both the contents of the buphthalmic globe and coelomic mass were consistent with Cryptococcus species. Initial results were later confirmed with serum antigen latex agglutination and polymerase chain reaction testing, and the organism was then identified as Cryptococcus neoformans with DNA sequencing...
December 2017: Journal of Avian Medicine and Surgery
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