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Neuroinfectious Diseases
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Jeremy D. Young, Jesica A. Herrick, Scott Borgetti
A key component of managing cryptococcosis is reestablishing immune function, either with cART in HIV infection or the decrease of immune suppression, as is feasible, in organ transplantation. One must remain aware of IRIS, leading to an exacerbation of symptoms or development of acute meningeal signs or lymphadenopathy. In fact, it is recommended to delay cART initiation by at least 2 weeks in patients with CNS cryptococcosis as some studies have demonstrated increased IRIS-related mortality in patients started on therapy earlier.10
Unexplained Fever in Infectious Diseases Section 1: Viruses, Chlamydia, Mycoplasma, Rickettsiae, Higher Bacteria, Cell-Wall Deficient Bacteria, And Fungi
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Cryptococcosis is a cosmopolitan subacute or chronic disease caused by the encapsulated yeast Cryptococcus neoformans. The organism is found abundantly in pigeon excreta and less often in other avian excreta and in the soil. The presumed portal of entry is the respiratory tract, then the lung is the initial focus of the infection, which usually spontaneously resolves but is sometimes hematogenously disseminated to any part of the body, primarily the central nervous system.111,142,143,145
Cryptococcus
Published in Rossana de Aguiar Cordeiro, Pocket Guide to Mycological Diagnosis, 2019
Luciana Trilles, Márcia dos Santos Lazéra, Bodo Wanke
Cryptococcosis manifests as a respiratory, disseminated, or meningeal disease. The pattern of cryptococcal pulmonary disease varies, ranging from asymptomatic to acute respiratory distress syndrome. The symptomatology is not specific, and thoracic discomfort and image finding in an immunocompetent host are not rare. Pulmonary cryptococcal disease in an immunocompetent host may manifest as a peripheral nodule, subpleural and sometimes eccentric, usually single, well defined, non-calcified, without evident pleural effusion. Pulmonary cryptococcosis should be considered on a differential diagnosis for nodular or mass-like lesions in chest radiograph, as it often mimics lung cancer (Kim et al., 2012).
Incidence and clinical outcome of Cryptococcosis in a nation with advanced HIV surveillance program
Published in The Aging Male, 2020
Fatma Ben Abid, Hussam Abdel Rahman S. Al Soub, Muna Al Maslamani, Wanis Hamad Ibrahim, Hafedh Ghazouani, Abdullatif Al-Khal, Saad Taj-Aldeen
Cryptococcosis is a systemic opportunistic fungal infection mainly caused by yeasts belonging to two species complexes: Cryptococcus neoformans and Cryptococcus gattii. Furthermore, few cases of Cryptococcus Laurentii causing human infection were reported in literature. Cryptococcal infections are mostly seen in immunocompromised patients, particularly those with cellular immune defects including advanced HIV infection with predilection of central nervous system [1–4]. The clinical presentation is usually subtle, vague, and indolent over a period of one to two weeks. The prognosis depends on early diagnosis, prompt use of antifungal drugs and reduction of the intracranial pressure. We carried out a retrospective observational study to determine the epidemiological and clinical characteristics of cryptococcosis in the State of Qatar, a country with low HIV prevalence and good surveillance program.
Endemic pulmonary fungal diseases in immunocompetent patients: an emphasis on thoracic imaging
Published in Expert Review of Respiratory Medicine, 2019
Ana Luiza Di Mango, Gláucia Zanetti, Diana Penha, Miriam Menna Barreto, Edson Marchiori
Cryptococcosis is caused by Cryptococcus spp, a ubiquitous encapsulated yeast like fungus. There are more than 30 species in the environment but only 2 are related to human disease, C. neoformans and C. gatti. Although C. neoformans may cause disease in immunocompetent hosts, it is considered an opportunistic fungal infection that mainly occur in immunosuppressed individuals. It is found worldwide and is associated with decaying wood and bird excreta such as pigeons. On the other hand, C. gatti is considered an endemic mycosis and mainly occurs in immunocompetent individuals. It has a more distinct geographic distribution, being more common on tropical and subtropical areas, such as Australia, Central America, parts of South America and Papua New Guinea, with the primary environmental sources being trees, mainly eucalyptus [74–77].
Future perspectives for cryptococcosis treatment
Published in Expert Opinion on Therapeutic Patents, 2018
Juliana Santos-Gandelman, Márcio Lourenço Rodrigues, Alice Machado Silva
Cryptococcosis is one of the most devastating human fungal infections. This is mostly due to the ability of this microorganism to infect the human brain, causing meningitis/meningoencephalitis in people living with HIV–AIDS [4]. According to a recent study, cryptococcosis remains the second most prevalent cause of death in AIDS patients, accounting for 15% of all AIDS-related deaths [5]. This same study estimated the global incidence of cryptococcal meningitis in HIV patients as 223.100 cases per year, having resulted in around 181.100 deaths in 2014. Sub-Saharan Africa still has the highest burden of HIV-associated cryptococcal disease, with 75% of global death cases [5]. Though the genus Cryptococcus comprises 10 members, human diseases associated to the genus are most frequently caused by C. neoformans and C. gattii [6].