New Insights Into Cryptococcus Spp. Biology and Cryptococcal Meningitis

AbstractPurpose of ReviewDefective cell –mediated immunity is a major risk factor for cryptococcosis, a fatal disease if untreated. Cryptococcal meningitis (CM), the main presentation of disseminated disease, occurs through hematogenous spread to the brain from primary pulmonary foci, facilitated by yeast virulence factors. We revisit r emarkable recent improvements in the prevention, diagnosis and management of CM.Recent FindingsCryptococcal antigen (CrAg), main capsular polysaccharide ofCryptococcus spp. is detectable in blood and cerebrospinal fluid of infected patients with point of care lateral flow assays. Recent World Health Organization guidelines recommend 7-day amphotericin B plus flucytosine, then 7-day high dose (1200  mg/day) fluconazole for induction treatment of HIV-associated CM. Management of raised intracranial pressure, a consequence of CM, should rely mainly on daily therapeutic lumbar punctures until normalisation. In HIV-associated CM, following introduction of antifungal therapy, (re)initiation of ant iretroviral therapy should be delayed by 4–6 weeks to prevent immune reconstitution inflammatory syndrome, common in CM.SummaryCM is a fatal disease whose diagnosis has recently been simplified. Treatment should always include antifungal combination therapy and management of raised intracranial pressure. Screening for immune deficiency should be mandatory in all patients with cryptococcosis.
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research

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Publication date: Available online 6 December 2019Source: Wilderness &Environmental MedicineAuthor(s): James H. DiazCryptococcus neoformans, a soil-dwelling fungus found worldwide, can cause cryptococcosis, an opportunistic fungal infection of the lungs and central nervous system. One former member of the C neoformans complex, Cryptococcus gattii, has caused meningitis in immunosuppressed and immunocompetent persons in endemic regions in Africa and Asia. Between 1999 and 2004, C gattii caused outbreaks of human cryptococcosis in unexpected, nonendemic, nontropical regions on Vancouver Island, Canada, and throughout the...
Source: Wilderness and Environmental Medicine - Category: Environmental Health Source Type: research
In conclusion, patients with liver disease have an increased risk of cryptococcosis. A high index of suspicion must be maintained for infection and should be considered in patients with recurrent effusions.
Source: Infectious Diseases in Clinical Practice - Category: Infectious Diseases Tags: Case Reports Source Type: research
Abstract Meningitis due to Cryptococcus neoformans is responsible for upwards of 180,000 deaths worldwide annually, mostly in immunocompromised individuals. Currently there are no licensed fungal vaccines, and even with anti-fungal drug treatment, cryptococcal meningitis is often fatal. Our lab previously demonstrated vaccination with recombinant cryptococcal proteins delivered in glucan particles (GPs) protects mice against an otherwise lethal infection. The aim of the present study was to discover additional cryptococcal antigens affording vaccine-mediated protection. Sixteen proteins, each with evidence of extr...
Source: Vaccine - Category: Allergy & Immunology Authors: Tags: Vaccine Source Type: research
CONCLUSIONS: Cryptococcal ocular involvement in AIDS patients has been occasionally proved among the cases already reported. Thus, the post mortem exam is still pivotal to improve the quality of the clinical diagnosis, especially in limited-resource settings. PMID: 31676212 [PubMed - as supplied by publisher]
Source: Revista Iberoamericana de Micologia - Category: Biology Authors: Tags: Rev Iberoam Micol Source Type: research
Purpose of review Describe the range of infectious causes of ocular motor neuropathies, from common presentations to unusual manifestations of diseases less frequently seen in the developed world. Provide information on recent developments in diagnostic testing for pathogens that may cause ocular motor neuropathies. Recent findings Antigen detection in serum or CSF has improved the diagnosis of cryptococcal disease. Cartridge PCR testing for tuberculosis has increased diagnostic accuracy, though tuberculous meningitis remains difficult to diagnose. Rapid, multiplex PCR and unbiased sequencing allow for diagnosis of a ...
Source: Current Opinion in Ophthalmology - Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research
Authors: Trovero AC, Mazza M, Rogé A, Rivas MC, Bordagorría X, Bruno S, Davel G Abstract Cryptococcosis is a fungal disease affecting more than one million people per year worldwide. Its main etiological agents are Cryptococcus neoformans species complex and Cryptococcus gattii species complex. Cryptococcal meningitis (CM) is considered an AIDS-defining condition. Rapid diagnosis by cryptococcal antigen assays, either the latex agglutination test (LA) or the lateral flow assay, is key to decreasing mortality due to cryptococcal disease. The aim of the study was to develop a latex agglutination reagent...
Source: Revista Argentina de Microbiologia - Category: Microbiology Tags: Rev Argent Microbiol Source Type: research
Cryptococcal meningitis (CM) is the most common type of cryptococcosis, accounting for about 77 –80% of all cryptococcal infections (Park et al., 2009; Makadzange and McHugh, 2014; Hoang et al., 2011; Sloan and Parris, 2014; Bratton et al., 2012). The main clinical manifestations of CM include fever and high intracranial pressure (ICP), presenting as headache, nausea, and vomiting. Damage to the cranial nerves may lead to vision loss, mental aberrations, consciousness disorders, and hearing loss (Chen et al., 2008; Liu et al., 2018).
Source: International Journal of Infectious Diseases - Category: Infectious Diseases Authors: Source Type: research
ConclusionsThis study is relevant because it shows the magnitude of cryptococcosis mortality linked to AIDS and removes the invisibility of a particular non-AIDS-related disease, accounting for almost 20% of all cryptococcosis deaths. It can also contribute to control and surveillance programs, beyond highlighting the urgent prioritization of early diagnosis and proper treatment to reduce the unacceptable mortality rate of this neglected mycosis in Brazil.
Source: PLoS Neglected Tropical Diseases - Category: Tropical Medicine Authors: Source Type: research
ConclusionsThis study is relevant because it shows the magnitude of cryptococcosis mortality linked to AIDS and removes the invisibility of a particular non-AIDS-related disease, accounting for almost 20% of all cryptococcosis deaths. It can also contribute to control and surveillance programs, beyond highlighting the urgent prioritization of early diagnosis and proper treatment to reduce the unacceptable mortality rate of this neglected mycosis in Brazil.
Source: PLoS Neglected Tropical Diseases - Category: Tropical Medicine Authors: Source Type: research
AbstractPurpose of ReviewTo perform an extensive review of recent literature and provide an update on the current epidemiology, clinical features, and management of cryptococcal disease with a focus on the differences between patients depending on their immune status.Recent FindingsEmerging literature has highlighted the inflammatory pathophysiology and varied manifestations of cryptococcal infections in patients who are apparently healthy but paradoxically have a more critical clinical course compared with their immunosuppressed counterparts.SummaryNon-HIV cryptococcal meningitis has greater mortality compared with that s...
Source: Current Fungal Infection Reports - Category: Infectious Diseases Source Type: research
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