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https://www.readbyqxmd.com/read/29454181/brainstem-dysfunction-heralding-disseminated-cryptococcosis
#1
Prachaya Srivanitchapoom, Yuvadee Pitakpatapee, Panitta Sitthinamsuwan, Sith Sathornsumetee
Cryptococcal meningoencephalitis is one of the most common central nervous system infections affecting immunocompromised patients. However, brainstem involvement is extremely rare and may represent a diagnostic challenge to clinicians. We report a non-HIV infected, chronically immunosuppressed, patient with fatal disseminated cryptococcosis presented with subcutaneous masses at both thighs and progressive brainstem dysfunction. Magnetic resonance imaging demonstrated multiple brainstem infarcts likely derived from small vessel vasculopathy...
February 12, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29451598/performance-of-cryptococcal-antigen-lateral-flow-assay-in-serum-cerebrospinal-fluid-whole-blood-and-urine-in-hiv-infected-patients-with-culture-proven-cryptococcal-meningitis-admitted-at-a-brazilian-referral-center
#2
José E Vidal, Carolina Toniolo, Adriana Paulino, Arnaldo L Colombo, Marilena Dos Anjos Martins, Cristina da Silva Meira, Renata Guise Soares Azevedo, Vera Lucia Pereira-Chioccola, Hélio Rodrigues Gomes, Marcia Dos Santos Lazera, Augusto C Penalva de Oliveira, David R Boulware
Cryptococcal meningitis is the most common cause of opportunistic meningitis in HIV-infected patients in Brazil and causes unacceptable high mortality rates. In this study, HIV-infected patients with a first episode of culture-proven cryptococcal meningitis in cerebrospinal fluid (CSF) were prospectively included in order to evaluate sensitivity of cryptococcal antigen (CrAg) lateral flow assay (LFA) in serum, CSF, whole blood (fingerstick), and fresh urine. In addition, HIV-infected patients with other neurological confirmed diseases were included in order to evaluate the specificity of CrAg LFA in serum...
2018: Revista do Instituto de Medicina Tropical de São Paulo
https://www.readbyqxmd.com/read/29436899/the-capsule-of-cryptococcus-neoformans
#3
Arturo Casadevall, Carolina Coelho, Radames J B Cordero, Quigly Dragotakes, Eric Jung, Raghav Vij, Maggie P Wear
The capsule of Cryptococcus neoformans is its dominant virulence factor and plays a key role in the biology of this fungus. In this essay, we focus on the capsule as a cellular structure and note the limitations inherent in the current methodologies available for its study. Given that no single method can provide the structure of the capsule, our notions of what is the cryptococcal capsule must be arrived at by synthesizing information gathered from very different methodological approaches including microscopy, polysaccharide chemistry and physical chemistry of macromolecules...
February 13, 2018: Virulence
https://www.readbyqxmd.com/read/29432047/community-acquired-meningitis-in-hiv-infected-patients-in-the-united-states
#4
Karen J Vigil, Lucrecia Salazar, Rodrigo Hasbun
We conducted a retrospective study of 549 adults admitted with community-acquired meningitis (CAM) to several hospitals in New Orleans, LA and Houston, TX between 1999 and 2014 to characterize the current epidemiology, clinical manifestations, cerebrospinal fluid (CSF) characteristics, and outcomes of CAM between HIV-infected and uninfected patients and to identify risk factors for adverse outcomes in CAM. Bivariate analysis and logistic regression analysis were used to identify prognostic factors. A total of 1022 patients with CAM were screened...
February 2018: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/29423423/rapid-reversal-of-complete-binocular-blindness-with-high-dose-corticosteroids-and-lumbar-drain-in-a-solid-organ-transplant-recipient-with-cryptococcal-meningitis-and-immune-reconstitution-syndrome-first-case-study-and-literature-review
#5
Zoe Weiss, Nihaal Mehta, Su Nandar Aung, Michael Migliori, Dimitrios Farmakiotis
Blindness is a rare, devastating, usually permanent complication of cryptococcal meningitis (CM). We present the first case of complete vision loss in a solid organ transplant recipient with CM treated with placement of a lumbar drain who had a dramatic visual recovery that started after 3 doses of high-dose steroids.
February 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29422616/identification-of-t-helper-th-1-and-th2-associated-antigens-of-cryptococcus-neoformans-in-a-murine-model-of-pulmonary-infection
#6
Carolina Firacative, A Elisabeth Gressler, Kristin Schubert, Bianca Schulze, Uwe Müller, Frank Brombacher, Martin von Bergen, Gottfried Alber
Cryptococcosis, caused by Cryptococcus neoformans, has been demonstrated to be controlled by T helper (Th)1 cells while Th2 cells are associated with fungal growth and dissemination. Although cryptococcal immunoreactive protein antigens were previously identified, their association with Th1 or Th2 immune responses was not provided. In mice, Th1-dependent IFN-γ induces the production of IgG2a, whereas the Th2 cytokine IL-4 stimulates the expression of IgG1 rendering each isotype an indicator of the underlying Th cell response...
February 8, 2018: Scientific 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
#7
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/29407335/late-steroid-withdrawal-following-ab0-incompatible-renal-transplantation
#8
F Bachmann, N Lachmann, K Budde, L Liefeldt, F Halleck, M Naik, F Friedersdorff, B Rudolph, K Wu, O Meyer, T Slowinski, J Waiser
BACKGROUND: Current evidence on steroid withdrawal following AB0-incompatible (AB0i) renal transplantation is low. We compared clinical outcomes of patients who agreed to late steroid withdrawal and patients who remained on steroid treatment. METHODS: Steroid withdrawal was carried out in 11 patients at ≥12 months after transplantation (group W). For comparison, we analyzed 19 patients who remained on triple immunosuppression including steroids (group M). Minimum follow-up was 24 months following transplantation and 12 months after steroid withdrawal...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29382737/udp-glucuronic-acid-transport-is-required-for-virulence-of-cryptococcus-neoformans
#9
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/29379704/paradoxical-respiratory-failure-due-to-cryptococcal-pneumonia-after-amphotericin-b-treatment-for-hiv-associated-cryptococcal-meningitis
#10
James E Scriven, Francois Cj Botha, Charlotte Schutz, David G Lalloo, Helen Wainwright, Graeme Meintjes
We present a 27-year-old lady with HIV-1 infection who died due to rapidly worsening respiratory failure one day after commencing amphotericin B deoxycholate therapy for cryptococcal meningitis. Chest x-ray appearances were consistent with pneumocystis pneumonia but post mortem examination showed evidence of severe necrotizing cryptococcal pneumonia. Cryptococcal pneumonia is an underrecognized condition and should be considered in the differential of patients with HIV-1 infection and low CD4 count who develop respiratory symptoms...
March 2018: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/29377368/a-systematic-review-of-fluconazole-resistance-in-clinical-isolates-of-cryptococcus-species
#11
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 of Cryptococcus spp. clinical isolates in 29 studies from 1988 to May 2017 included in EMBASE and MEDLINE databases. A total of 4,995 Cryptococcus isolates from 3,210 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
#12
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/29374464/disseminated-cryptococcosis-presenting-initially-as-lower-limb-cellulitis-in-a-renal-transplant-recipient-a-case-report
#13
Katrina Chakradeo, Y Y Paul Chia, Cheng Liu, David W Mudge, Janath De Silva
BACKGROUND: Cellulitis is an unusual presentation of disseminated cryptococcosis, a serious infection seen predominantly in immunocompromised hosts. Disseminated cryptococcosis carries significant morbidity for transplant recipients, especially of the pulmonary and central nervous systems, and carries a high mortality risk. CASE PRESENTATION: We report a 59-year-old renal transplant recipient who presented with bilateral lower leg cellulitis without other symptoms or signs...
January 27, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29373741/high-rates-of-cerebral-toxoplasmosis-in-hiv-patients-presenting-with-meningitis-in-accra-ghana
#14
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/29373342/choriocapillaris-flow-voids-in-cryptococcal-choroiditis-using-optical-coherence-tomography-angiography
#15
Daniel M Vu, Akshay S Thomas, Avni P Finn, Dilraj S Grewal
PURPOSE: To report an unusual case of cryptococcal choroiditis and highlight the multimodal imaging findings, particularly the choriocapillaris flow voids using optical coherence tomography angiography. METHODS: Retrospective review of the clinical course of a single patient with cryptococcal choroiditis. RESULTS: A 69-year-old man undergoing chemotherapy for T-cell prolymphocytic leukemia developed disseminated crytococcal neoformans infection...
January 25, 2018: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/29372172/cryptococcal-disease-in-the-era-of-test-and-treat-is-there-cause-for-concern
#16
Mahsa Abassi, Joshua Rhein, David B Meya, David R Boulware
Treatment of cryptococcosis requires deferred initiation of antiretroviral therapy (ART). Early ART initiation may be detrimental in the context of cryptococcal infection by increasing the risk of immune reconstitution inflammatory syndrome (IRIS). We present 3 cases where early ART initiation in the presence of unrecognized cryptococcal disease had fatal outcomes.
January 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29371581/hiv-associated-cryptococcal-disease-in-resource-limited-settings-a-case-for-prevention-is-better-than-cure
#17
REVIEW
Rita O Oladele, Felix Bongomin, Sara Gago, David W Denning
Cryptococcal disease remains a significant source of global morbidity and mortality for people living with HIV, especially in resource-limited settings. The recently updated estimate of cryptococcal disease revealed a global incidence of 223,100 cases annually with 73% of these cases being diagnosed in sub-Saharan Africa. Furthermore, 75% of the estimated 181,100 deaths associated with cryptococcal disease occur in sub-Saharan Africa. Point-of-care diagnostic assays have revolutionised the diagnosis of this deadly opportunistic infection...
December 2, 2017: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29371573/global-and-multi-national-prevalence-of-fungal-diseases-estimate-precision
#18
REVIEW
Felix Bongomin, Sara Gago, Rita O Oladele, David W Denning
Fungal diseases kill more than 1.5 million and affect over a billion people. However, they are still a neglected topic by public health authorities even though most deaths from fungal diseases are avoidable. Serious fungal infections occur as a consequence of other health problems including asthma, AIDS, cancer, organ transplantation and corticosteroid therapies. Early accurate diagnosis allows prompt antifungal therapy; however this is often delayed or unavailable leading to death, serious chronic illness or blindness...
October 18, 2017: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29371569/cryptococcus-epithelial-interactions
#19
REVIEW
Leanne M Taylor-Smith
The fungal pathogen, Cryptococcus neoformans, causes devastating levels of morbidity and mortality. Infections with this fungus tend to be predominantly in immunocompromised individuals, such as those with HIV. Infections initiate with inhalation of cryptococcal cells and entry of the pathogen into the lungs. The bronchial epithelial cells of the upper airway and the alveolar epithelial cells of the lower airway are likely to be the first host cells that Cryptococcus engage with. Thus the interaction of cryptococci and the respiratory epithelia will be the focus of this review...
October 2, 2017: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29371559/the-effect-of-novel-heterocyclic-compounds-on-cryptococcal-biofilm
#20
Maya Korem, Sarah Kagan, Itzhack Polacheck
Biofilm formation by microorganisms depends on their communication by quorum sensing, which is mediated by small diffusible signaling molecules that accumulate in the extracellular environment. During human infection, the pathogenic yeast Cryptococcus neoformans can form biofilm on medical devices, which protects the organism and increases its resistance to antifungal agents. The aim of this study was to test two novel heterocyclic compounds, S-8 (thiazolidinedione derivative, TZD) and NA-8 (succinimide derivative, SI), for their anti-biofilm activity against strains of Cryptococcus neoformans and Cryptococcus gattii...
July 20, 2017: Journal of Fungi (Basel, Switzerland)
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