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https://www.readbyqxmd.com/read/28820702/predictive-model-for-permanent-shunting-in-cryptococcal-meningitis
#1
Woralux Phusoongnern, Siriluck Anunnatsiri, Kittisak Sawanyawisuth, Amnat Kitkhuandee
Cryptococcal meningitis may have long-term morbidity and requires a permanent cerebrospinal fluid shunt. This study aimed to evaluate the risk factors and create a predictive model for permanent shunt treatment in cryptococcal meningitis patients. This was a retrospective analytical study conducted at Khon Kaen University. The study period was from January 2005 to December 2015. We enrolled all adult patients diagnosed with cryptococcal meningitis. Risk factors predictive for permanent shunting treatment were analyzed by multivariate logistic regression analysis...
August 14, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28815430/clinical-evaluation-of-the-antifungal-effect-of-sertraline-in-the-treatment-of-cryptococcal-meningitis-in-hiv-patients-a-single-mexican-center-experience
#2
Hiram Villanueva-Lozano, Rogelio de J Treviño-Rangel, Gloria M González, Pedro A Hernández-Rodríguez, Adrián Camacho-Ortiz, Luis Castillo-Reyna, Sandra G Galindo-Alvarado, Michel F Martínez-Reséndez
PURPOSE: Cryptococcal meningitis is a potentially fatal fungal infection associated with a significant attributable morbidity and mortality, especially among HIV/AIDS patients. The first-line therapy for the treatment of this clinical entity is the combinatory therapy of amphotericin B plus flucytosine. However, the high cost, toxic effects, and limited repertoire of effective antifungal drugs have led to the investigation of novel molecules. This is a prospective, double-blinded, and randomized study performed in a Mexican tertiary care center to evaluate the antifungal activity of sertraline in the treatment of cryptococcal meningitis in HIV patients...
August 16, 2017: Infection
https://www.readbyqxmd.com/read/28807740/outcomes-of-hiv-positive-patients-with-cryptococcal-meningitis-in-the-americas
#3
B Crabtree Ramírez, Y Caro Vega, B E Shepherd, C Le, M Turner, C Frola, B Grinsztejn, C Cortes, D Padgett, T R Sterling, C C McGowan, A Person
BACKGROUND: Cryptococcal meningitis (CM) is associated with substantial mortality in HIV-infected patients. Optimal timing of antiretroviral therapy (ART) in persons with CM represents a clinical challenge, and the burden of CM in Latin America has not been well described. Studies suggest that early ART initiation is associated with higher mortality, but data from the Americas are scarce. METHODS: HIV-infected adults in care between 1985-2014 at participating sites in the Latin America (the Caribbean, Central and South America network (CCASAnet)) and the Vanderbilt Comprehensive Care Clinic (VCCC) and who had CM were included...
August 11, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28806629/aseptic-meningitis-in-adults-and-children-diagnostic-and-management-challenges
#4
Bhavarth Shukla, Elizabeth A Aguilera, Lucrecia Salazar, Susan H Wootton, Quanhathai Kaewpoowat, Rodrigo Hasbun
BACKGROUND: Aseptic meningitis represents a common diagnostic and management dilemma to clinicians. OBJECTIVES: To compare the clinical epidemiology, diagnostic evaluations, management, and outcomes between adults and children with aseptic meningitis. STUDY DESIGN: We conducted a retrospective study from January 2005 through September 2010 at 9 Memorial Hermann Hospitals in Houston, TX. Patients age≥2months who presented with community-acquired aseptic meningitis with a CSF white blood cell count >5cells/mm(3) and a negative Gram stain and cultures were enrolled...
August 4, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28799299/a-comparative-study-of-csf-viral-rna-loads-between-hiv-positive-patients-with-neurological-manifestations-and-neurologically-asymptomatic-hiv-patients
#5
A D Mathur, S Devesh
INTRODUCTION: There are conflicting reports in literature about correlation of CSF viral RNA levels with neurological manifestations in HIV positive patients. Many studies in animals and human subjects have shown that CSF HIV-1 RNA can be useful as a specific marker of HIV induced neuropathology. To the contrary there are studies which show that neurological disease states can occur in absence of significant increase of CSF HIV RNA. MATERIALS AND METHODS: This was a prospective study conducted at Base hospital Delhi Cantt, New Delhi, a tertiary care hospitals for HIV patients...
August 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28797488/cryptococcal-lung-infections
#6
REVIEW
Kate Skolnik, Shaunna Huston, Christopher H Mody
Cryptococcus is among the most common invasive fungal pathogens globally and is one of the leading causes of acquired immunodeficiency virus-related deaths. Cryptococcus neoformans and Cryptococcus gattii are the most clinically relevant species and account for most cryptococcal disease. Pulmonary manifestations can range from mild symptoms to life-threatening infection. Treatment is tailored based on the severity of pulmonary infection, the presence of disseminated or central nervous system disease, and patient immune status...
September 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28793877/subarachnoid-small-vein-occlusion-due-to-inflammatory-fibrosis-a-possible-mechanism-for-cerebellar-infarction-in-cryptococcal-meningoencephalitis-a-case-report
#7
Yoshiteru Shimoda, Satoru Ohtomo, Hiroaki Arai, Takashi Ohtoh, Teiji Tominaga
BACKGROUND: Cryptococcal meningoencephalitis (CM) causes cerebral infarction, typically, lacunar infarction in the basal ganglia. However, massive cerebral infarction leading to death is rare and its pathophysiology is unclear. We report a case of CM causing massive cerebellar infarction, which led to cerebral herniation and death. CASE PRESENTATION: A 56-year-old man who suffered from dizziness and gait disturbance for one month was admitted to our hospital and subsequently diagnosed with a cerebellar infarction...
August 9, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28793057/noninvasive-intracranial-pressure-monitoring-for-hiv-associated-cryptococcal-meningitis
#8
V R Bollela, G Frigieri, F C Vilar, D L Spavieri, F J Tallarico, G M Tallarico, R A P Andrade, T M de Haes, O M Takayanagui, A M Catai, S Mascarenhas
Mortality and adverse neurologic sequelae from HIV-associated cryptococcal meningitis (HIV-CM) remains high due to raised intracranial pressure (ICP) complications. Cerebrospinal fluid (CSF) high opening pressure occurs in more than 50% of HIV-CM patients. Repeated lumbar puncture with CSF drainage and external lumbar drainage might be required in the management of these patients. Usually, there is a high grade of uncertainty and the basis for clinical decisions regarding ICP hypertension tends to be from clinical findings (headache, nausea and vomiting), a low Glasgow coma scale score, and/or fundoscopic papilledema...
August 7, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
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
#9
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/28790866/incidence-clinical-presentation-and-outcome-of-hiv-1-associated-cryptococcal-meningitis-during-the-highly-active-antiretroviral-therapy-era-a-nationwide-cohort-study
#10
Madeleine Touma, Line D Rasmussen, Raquel Martin-Iguacel, Frederik Neess Engsig, Nina Breinholt Stærke, Mette Stærkind, Niels Obel, Magnus Glindvad Ahlström
BACKGROUND: Human immunodeficiency virus (HIV) infection with advanced immunosuppression predisposes to cryptococcal meningitis (CM). We describe the incidence, clinical presentation, and outcome of CM in HIV-infected individuals during the highly active antiretroviral therapy (HAART) era. METHODS: A nationwide, population-based cohort of HIV-infected individuals was used to estimate incidence and mortality of CM including risk factors. A description of neurological symptoms of CM at presentation and follow-up in the study period 1995-2014 was included in this study...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28783390/cryptococcal-meningitis
#11
Damien K Ming, Thomas S Harrison
No abstract text is available yet for this article.
August 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28776195/clinical-characteristics-and-prognosis-of-pediatric-cryptococcosis-in-beijing-children-s-hospital-2002-2014
#12
Linlin Liu, Lingyun Guo, Yue Liu, Tianming Chen, Shaoying Li, Yonghong Yang, Gang Liu
Cryptococcosis is a rare pediatric disease. The aim of the study is to describe clinical characteristics and prognosis of pediatric cryptococcosis from 2002 to 2014 in Beijing Children's Hospital. A total of 53 cases of cryptococcosis were identified, 69.8% of which were males. The mean age was 7 years. Forty-one (77.4%) patients had no underlying conditions. Fever, headache, and vomiting were the most common symptoms. The most common sites were the central nervous system (CNS), followed by the lungs. Most patients received a combination of amphotericin B and fluconazole with or without flucytosine as their initial regimen...
August 3, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28775082/disseminated-cryptococcal-infection-in-a-patient-who-had-kidney-transplant-discrepancy-between-clinical-symptoms-and-microbiological-findings
#13
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/28774293/the-clinical-utility-of-the-urine-based-lateral-flow-lipoarabinomannan-assay-in-hiv-infected-adults-in-myanmar-an-observational-study
#14
Swe Swe Thit, Ne Myo Aung, Zaw Win Htet, Mark A Boyd, Htin Aung Saw, Nicholas M Anstey, Tint Tint Kyi, David A Cooper, Mar Mar Kyi, Josh Hanson
BACKGROUND: The use of the point-of-care lateral flow lipoarabinomannan (LF-LAM) test may expedite tuberculosis (TB) diagnosis in HIV-positive patients. However, the test's clinical utility is poorly defined outside sub-Saharan Africa. METHODS: The study enrolled consecutive HIV-positive adults at a tertiary referral hospital in Yangon, Myanmar. On enrolment, patients had a LF-LAM test performed according to the manufacturer's instructions. Clinicians managing the patients were unaware of the LF-LAM result, which was correlated with the patient's clinical course over the ensuing 6 months...
August 4, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28752102/acute-kidney-injury-and-urinary-biomarkers-in-human-immunodeficiency-virus-associated-cryptococcal-meningitis
#15
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
#16
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/28747366/cross-reacting-ustilago-maydis-causing-false-positive-cryptococcal-antigen-tests
#17
Matthew P Cheng, Tien T Nguyen, Leighanne O Parkes, Philippe J Dufresne, Donald C Sheppard
Cryptococcus neoformans is a yeast within the division Basidiomycota that may cause pulmonary and central nervous system (CNS) disease.….
July 26, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28744276/differential-antifungal-activity-of-human-and-cryptococcal-melanins-with-structural-discrepancies
#18
Néstor Correa, Cristian Covarrubias, Paula I Rodas, Germán Hermosilla, Verónica R Olate, Cristián Valdés, Wieland Meyer, Fabien Magne, Cecilia V Tapia
Melanin is a pigment found in all biological kingdoms, and plays a key role in protection against ultraviolet radiation, oxidizing agents, and ionizing radiation damage. Melanin exerts an antimicrobial activity against bacteria, fungi, and parasites. We demonstrated an antifungal activity of synthetic and human melanin against Candida sp. The members of the Cryptococcus neoformans and C. gattii species complexes are capsulated yeasts, which cause cryptococcosis. For both species melanin is an important virulence factor...
2017: Frontiers in Microbiology
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
#19
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/28723333/enhanced-prophylaxis-plus-antiretroviral-therapy-for-advanced-hiv-infection-in-africa
#20
RANDOMIZED CONTROLLED TRIAL
James Hakim, Victor Musiime, Alex J Szubert, Jane Mallewa, Abraham Siika, Clara Agutu, Simon Walker, Sarah L Pett, Mutsa Bwakura-Dangarembizi, Abbas Lugemwa, Symon Kaunda, Mercy Karoney, Godfrey Musoro, Sheila Kabahenda, Kusum Nathoo, Kathryn Maitland, Anna Griffiths, Margaret J Thomason, Cissy Kityo, Peter Mugyenyi, Andrew J Prendergast, A Sarah Walker, Diana M Gibb
BACKGROUND: In sub-Saharan Africa, among patients with advanced human immunodeficiency virus (HIV) infection, the rate of death from infection (including tuberculosis and cryptococcus) shortly after the initiation of antiretroviral therapy (ART) is approximately 10%. METHODS: In this factorial open-label trial conducted in Uganda, Zimbabwe, Malawi, and Kenya, we enrolled HIV-infected adults and children 5 years of age or older who had not received previous ART and were starting ART with a CD4+ count of fewer than 100 cells per cubic millimeter...
July 20, 2017: New England Journal of Medicine
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