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Pathophysiology
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
viii – The initial signs and findings indicate meningitis.12 It is also determined from the history that the man had multiple partners and had been sexually active several years ago. These risk factors are specific to sexually transmitted diseases. The additional CSF findings indicate meningitis caused by Cryptococcus neoformans.13 This opportunistic fungal infection is characteristically found in patients with a low CD4 count infected with HIV.
Native And Acquired Resistance To Infection With Cryptococcus Neoformans
Published in Hans H. Gadebusch, Phagocytes and Cellular Immunity, 2020
Studies of the mechanisms whereby mammalian hosts ward off infection with Cryptococcus neoformans have spanned more than 3 decades and involved a score of investigators. These efforts have identified a plethora of specific and nonspecific defense mechanisms that restrict, destroy, and in certain cases, unfortunately, also permit the unhampered survival of these organisms in tissue.
Disseminated Histoplasmosis, Coccidioidomycosis, And Cryptococcosis
Published in Lourdes R. Laraya-Cuasay, Walter T. Hughes, Interstitial Lung Diseases in Children, 2019
The diagnosis is established by the demonstration of Cryptococcus neoformans in sputum or biopsy specimens from the infected lung by direct histological examination and isolation in culture. In the disseminated form the organism may be found in spinal fluid, urine, skin lesions, bone marrow, and blood. The organism cannot be definitely identified unless it is cultured, but the unique, thick capsule provides a characteristic useful in direct histologic examinations. The capsule of the yeast may be revealed with an India ink preparation or by a mucicarmine stain. Specimens for culture should be inoculated onto several Sabourand dextrose agar plates, without cycloheximide. The cryptococcal antigen test is a useful diagnostic aid, especially if central nervous system infection exists, but it is less sensitive with cryptococcosis limited to the lung. This latex agglutination test can be applied to spinal fluid, pleural fluid, serum, or urine. Approximately 90% of patients with meningitis will have detectable cryptococcal polysaccharide antigen in the spinal fluid.
Exploitation of the antifungal and antibiofilm activities of plumbagin against Cryptococcus neoformans
Published in Biofouling, 2022
Weidong Qian, Wenjing Wang, Jianing Zhang, Yuting Fu, Qiming Liu, Xinchen Li, Ting Wang, Qian Zhang
Cryptococcus neoformans is a ubiquitous encapsulated fungus, and a major opportunistic human fungal pathogen. However, it can trigger serious infections preferentially in immune-compromised individuals and occasionally in those with weakened immunocompromised systems, being responsible for an estimated 220,000 cases of C. neoformans infections every year globally (Rajasingham et al. 2017). It can cause life-threatening meningitis and fungemia (Lin et al. 2015). Most human C. neoformans infections result from the inhalation of aerosolized cryptococcal yeast or basidiospores that are ubiquitous in various natural environments (Toberna et al. 2020). Such ubiquity of C. neoformans in the environment can be partly attributed to its ability to adapt to varying environmental conditions and to evade recognition and clearance by the immune system of humans. Recent studies have postulated that the capacity of Cryptococcus species to survive, proliferate, and thrive in diverse hostile niches exacerbates the virulence of the yeast in humans, leading to recurrent and difficult-to-treat infections (Brandao et al. 2015).
Advances in the pharmacological management of bacterial peritonitis
Published in Expert Opinion on Pharmacotherapy, 2021
Daniel Pörner, Sibylle Von Vietinghoff, Jacob Nattermann, Christian P Strassburg, Philipp Lutz
While bacteria are the most common cause of peritonitis, one should be aware that other infectious and noninfectious forms of peritonitis may occur. Viral peritonitis in humans is very uncommon. The few published case reports include peritonitis induced by Cytomegalovirus [6] and Coxsackievirus B virus [7]. Interestingly, in cats, coronavirus can cause a well-known veterinary disease, called feline infectious peritonitis [8]. However, similar conditions have not been described in humans. This applies also to the pandemic SARS coronavirus 2 (SARS-CoV-2). In contrast to viral peritonitis, fungal peritonitis is encountered rarely, but regularly. It occurs almost exclusively in patients with severe immunodeficiency such as AIDS, in patients with liver cirrhosis or on PD. In particular, infection with Cryptococcus neoformans may manifest as peritonitis [9]. In patients with cirrhosis, fungal peritonitis [10] is usually caused by Candida species and associated with a very poor prognosis. Similarly, in patients on PD, fungal peritonitis is most frequently caused by Candida species and usually necessitates at least temporary removal of the peritoneal catheter [11]. However, mortality of fungal peritonitis in patients on PD is lower than in patients with cirrhosis. Noninfectious peritonitis may occur in autoimmune diseases (e.g., systemic lupus erythematodes), after intraperitoneal application of antineoplastic agents or in the case of intraperitoneal bile leakage after injury to the biliary tract.
Disseminated cryptococcal infection in a patient with glioblastoma multiforme on treatment with lomustine and bevacizumab
Published in Baylor University Medical Center Proceedings, 2021
Adrienne M. Gonzales, Tauqeer Yousuf
Despite empiric treatment with cefepime and azithromycin, the patient continued to spike high fevers and around the 48- to 72-hour mark he had altered mental status. Given his somnolence, bronchoscopy was not an option due to the risks of the sedating agents. A neurological workup was initiated, but shortly afterwards the patient’s blood cultures returned positive for yeast. Micafungin was started while a fungal workup was initiated. Cryptococcus neoformans was ultimately identified on blood cultures and serology. Given this new information, the patient was transitioned to liposomal amphotericin B and flucytosine. Additionally, lumbar puncture was ordered to assess for opening pressure and presence of cryptococcal infection in the cerebrospinal fluid. Opening pressure was normal, but C. neoformans was present on fungal culture, meningitis/encephalitis polymerase chain reaction, and cerebrospinal fluid antigen.