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cryptococcus meningitis

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https://www.readbyqxmd.com/read/28355252/factors-associated-with-early-mycological-clearance-in-hiv-associated-cryptococcal-meningitis
#1
Fátima Concha-Velasco, Elsa González-Lagos, Carlos Seas, Beatriz Bustamante
INTRODUCTION: The first-line combination therapy for HIV-associated cryptococcal meningitis (CM), a condition of high mortality particularly in the first two weeks of treatment, consists of amphotericin B plus flucytosine (5-FC). Given that 5-FC remains unavailable in many countries, the knowledge of factors influencing mycological clearance in patients treated with second-line therapy could contribute to effective management. OBJECTIVES: To determine the factors associated with the clearance of Cryptococcus sp...
2017: PloS One
https://www.readbyqxmd.com/read/28348767/first-case-of-mixed-infection-with-cryptococcus-deuterogattii-and-cryptococcus-neoformans-vni-in-an-ivorian-hiv-positive-patient
#2
Fulgence K Kassi, Virginie Bellet, Adama Doumbia, Donika Krasteva, Pascal Drakulovski, Gisèle A Kouakou, François Gatchitch, Eric Delaporte, Jacques Reynes, Michèle Mallié, Hervé I E Menan, Sébastien Bertout
INTRODUCTION: Cryptococcal meningitis (CM) may be caused by several species of Cryptococcus. CASE PRESENTATION: We describe a fatal case of CM in a HIV-positive patient from Ivory Coast infected by Cryptococcus neoformans VNI and Cryptococcusdeuterogattii. Isolates were recovered from cerebrospinal fluid (CSF) prior to systemic antifungal treatment. Six isolates were studied (the entire culture plus five isolated colonies from it). Serotyping was performed via LAC 1 and CAP 64 gene amplification...
August 2016: JMM Case Reports
https://www.readbyqxmd.com/read/28346317/the-csf-immune-response-in-hiv-1-associated-cryptococcal-meningitis-macrophage-activation-correlates-of-disease-severity-and-effect-of-antiretroviral-therapy
#3
James E Scriven, Lisa M Graham, Charlotte Schutz, Thomas J Scriba, Katalin A Wilkinson, Robert J Wilkinson, David R Boulware, Britta C Urban, Graeme Meintjes, David G Lalloo
BACKGROUND: Immune modulation may improve outcome in HIV-associated cryptococcal meningitis. Animal studies suggest alternatively activated macrophages are detrimental but human studies are limited. We performed a detailed assessment of the cerebrospinal fluid (CSF) immune response and examined immune correlates of disease severity and poor outcome, and the effects of antiretroviral therapy (ART). METHODOLOGY: We enrolled persons ≥18 years with first episode of HIV-associated cryptococcal meningitis...
March 31, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28329080/differences-in-immunologic-factors-among-patients-presenting-with-altered-mental-status-during-cryptococcal-meningitis
#4
Sarah Lofgren, Kathy H Hullsiek, Bozena M Morawski, Henry W Nabeta, Reuben Kiggundu, Kabanda Taseera, Abdu Musubire, Charlotte Schutz, Mahsa Abassi, Nathan C Bahr, Lillian Tugume, Conrad Muzoora, Darlisha A Williams, Melissa A Rolfes, Sruti S Velamakanni, Radha Rajasingham, Graeme Meintjes, Joshua Rhein, David B Meya, David R Boulware
Altered mental status in cryptococcal meningitis results in poorer survival, but underlying causes of altered mentation are poorly understood. Within two clinical trials, we assessed risk factors for altered mental status (GCS score<15) considering baseline clinical characteristics, CSF cytokines/chemokines, and antiretroviral therapy. Among 326 enrolled participants, 97 (30%) had GCS<15 and these patients had lower median CSF cryptococcal antigen titers (P = .042) and CCL2 (P = .005) but higher opening pressures (320 vs...
March 1, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28270580/microevolution-of-serial-clinical-isolates-of-cryptococcus-neoformans-var-grubii-and-c-%C3%A2-gattii
#5
Yuan Chen, Rhys A Farrer, Charles Giamberardino, Sharadha Sakthikumar, Alexander Jones, Timothy Yang, Jennifer L Tenor, Omar Wagih, Marelize Van Wyk, Nelesh P Govender, Thomas G Mitchell, Anastasia P Litvintseva, Christina A Cuomo, John R Perfect
The pathogenic species of Cryptococcus are a major cause of mortality owing to severe infections in immunocompromised as well as immunocompetent individuals. Although antifungal treatment is usually effective, many patients relapse after treatment, and in such cases, comparative analyses of the genomes of incident and relapse isolates may reveal evidence of determinative, microevolutionary changes within the host. Here, we analyzed serial isolates cultured from cerebrospinal fluid specimens of 18 South African patients with recurrent cryptococcal meningitis...
March 7, 2017: MBio
https://www.readbyqxmd.com/read/28265742/connecting-virulence-pathways-to-cell-cycle-progression-in-the-fungal-pathogen-cryptococcus-neoformans
#6
REVIEW
Christina M Kelliher, Steven B Haase
Proliferation and host evasion are critical processes to understand at a basic biological level for improving infectious disease treatment options. The human fungal pathogen Cryptococcus neoformans causes fungal meningitis in immunocompromised individuals by proliferating in cerebrospinal fluid. Current antifungal drugs target "virulence factors" for disease, such as components of the cell wall and polysaccharide capsule in C. neoformans. However, mechanistic links between virulence pathways and the cell cycle are not as well studied...
March 6, 2017: Current Genetics
https://www.readbyqxmd.com/read/28251810/the-water-channel-protein-aquaporin-1-regulates-cellular-metabolism-and-competitive-fitness-in-a-global-fungal-pathogen-cryptococcus-neoformans
#7
Gena Lee Meyers, Kwang-Woo Jung, Soohyun Bang, Jungyeon Kim, Sooah Kim, Joohyeon Hong, Eunji Cheong, Kyoung Heon Kim, Yong-Sun Bahn
In this study, an aquaporin protein, Aqp1, in Cryptococcus neoformans, which can lead either saprobic or parasitic lifestyles and causes life-threatening fungal meningitis was identified and characterized. AQP1 expression was rapidly induced (via the HOG pathway) by osmotic or oxidative stress. In spite of such transcriptional regulation, Aqp1 was found to be largely unnecessary for adaptation to diverse environmental stressors, regardless of the presence of the polysaccharide capsule. The latter is shown here to be a key environmental-stress protectant for C...
March 2, 2017: Environmental Microbiology Reports
https://www.readbyqxmd.com/read/28247152/magnetic-resonance-imaging-study-of-cryptococcal-neuroradiological-lesions-in-hiv-negative-cryptococcal-meningitis
#8
Y Zhong, Z Zhou, X Fang, F Peng, W Zhang
Magnetic resonance (MR) scanning has become an important diagnostic and management tool in cryptococcal meningitis (CM). However, there are only isolated case reports documenting neuroradiological findings in human immunodeficiency virus (HIV)-negative patients with CM and none has clearly addressed the relationship between cerebral lesions on magnetic resonance imaging (MRI) and prognosis. The MR brain images available from 114 HIV-negative patients with CM were retrospectively analysed. Patients were divided into Group I with one or more CM-related lesions and Group II without CM-related lesions...
February 28, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28188180/a-population-genomics-approach-to-assessing-the-genetic-basis-of-within-host-microevolution-underlying-recurrent-cryptococcal-meningitis-infection
#9
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 (WGS) to assess the genetic basis of infection in 17 HIV-infected individuals with recurrent cryptococcal meningitis (CM). Comparisons revealed a clonal relationship for 15 pairs of isolates recovered before and after recurrence showing relapse of the original infection...
April 3, 2017: G3: Genes—Genomes—Genetics
https://www.readbyqxmd.com/read/28188169/cerebral-cryptococcoma-mimicking-glioblastoma
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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