Comparison of clinical and biological characteristics of HIV-infected patients presenting Cryptococcus neoformans versus C. curvatus/C. laurentii meningitis (original) (raw)
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Cryptococcus neoformans causing meningitis in AIDS patients
Revista Da Sociedade Brasileira De Medicina Tropical, 2002
Cryptococcus neoformans causes meningitis in AIDS patients. In the São José Hospital, reference center for patients with AIDS in Fortaleza-Ceará State-Brazil, 54 samples of the cerebrospinal fluid were analyzed from January 1 st through December 31 st 2000. Direct examination with India ink and culture in Sabouraud's agar at 37°C were done. Of the specimens studied 5(9.25%) were positive.
International journal of Pharmacy and Pharmaceutical Sciences, 2014
Objectives: This study was undertaken to determine the antifungal susceptibility of fifteen cryptococcal isolates from cerebrospinal fluid (CSF) of HIV seropositive patients with cryptococcal meningitis. Methods: Antifungal susceptibility testing of the isolates was done by CLSI M27 A-3 methodology for amphotericin B, fluconazole, voriconazole, itraconazole and 5-flucytosine. Results: Our study demonstrates no evidence of resistance among clinical isolates of Cryptococcus neoformans for any of the above mentioned antifungal drugs. Only two isolates showed slightly higher minimum inhibitory concentration (MIC) to 5-flucytosine (8 µg/ml). Conclusion:
Diagnostic Microbiology and Infectious Disease, 2016
Cryptococcus neoformans is the leading cause of cryptococcosis in HIV-infected subjects worldwide. Treatment of cryptococcosis is based on amphotericin B, flucytosine, and fluconazole. In Zimbabwe, little is known about antifungal susceptibility of Cryptococcus. Sixty-eight genotyped Cryptococcus isolates were tested for antifungal profiles. Amphotericin B, isavuconazole, and voriconazole showed higher activity than other triazoles. Fluconazole and flucytosine were less effective, with geometric mean MICs of 2.24 and 2.67 mg/L for C. neoformans AFLP1/VNI, 1.38 and 1.53 mg/L for C. neoformans AFLP1A/VNB/VNII and AFLP1B/VNII, and 1.85 and 0.68 mg/L for Cryptococcus tetragattii, respectively. A significant difference between flucytosine geometric mean MICs of C. neoformans and C. tetragattii was observed (P = 0.0002). The majority of isolates (n = 66/68; 97.1%) had a wild-type MIC phenotype of all antifungal agents. This study demonstrates a favorable situation with respect to the tested antifungals agents. Continued surveillance of antifungal susceptibility profiles is important due to the high burden of cryptococcosis in Africa.
Cryptococcal Meningitis amomg HIV-Infected and HIV-Uninfected Patients in Jos, North Central Nigeria
Journal of BioMedical Research and Clinical Practice
Cryptococcal meningitis is a global opportunistic infection caused by several serovars of Cryptococcus neoformans and Cryptococcus gattii with significant morbidity and mortality, particularly in immunocompromised patients. Management principles involve early and specific diagnosis followed by appropriate antifungal therapy. The study was conducted among in-patients with clinical features of meningitis admitted into tertiary healthcare facilities in Jos, north-central Nigeria from November 2017 to December 2018. Cerebrospinal fluid and blood samples were collected from the patients for culture and sensitivity, serology and genomic studies. Univariate and bivariate analysis was carried out using STATA (version 14IC). The serologic prevalence of cryptococcal meningitis among patients with clinical features of meningitis was 16.8%. The prevalence among HIV-infected and HIV-uninfected patients were 13.4% and 18.8% respectively. The antifungal susceptibility of the Cryptococcus neoforman...
Clinical Manifestations of Cryptococcal Meningitis in HIV Negative Patients-A Case Study
Cryptococcal Meningitis (CM) is a central nervous system infection caused by a fungus. A large majority of cases are caused by Cryptococcus neoformans var. neoformans. The fungus C. neoformans is found in soil that contains bird droppings, particularly pigeon excreta, all over the world. Cryptococcusneoformans var. gatti, on the other hand, is found primarily in tropical and subtropical regions trees, most commonly eucalyptus trees. It grows in the debris around the trees' bases. Cryptococcal meningitis usually occurs in people who have a compromised immune system and is a rare occurrence in someone who has a normal immune system. Of the two fungi, Cryptococcalgattii is the one more likely to infect someone with a normal immune system.The incidence of infections caused by C.neoformans has risen markedly over the past 20 years as a result of the HIV/AIDS epidemic and increasing use of immunosuppressive therapies. Cryptococcal meningitis is a common opportunistic infection and an AIDS-defining illness in patients with late-stage HIV infection, particularly in Southeast Asia and Southern and East Africa. It is widely considered as the most common life-threatening AIDS related fungal infection. Cryptococcal meningitis has been estimated at about 70 to 90% worldwide in AIDS patients with mortalities of between 50% to 70% in Sub-Saharan Africa. [2,3,4] Mortality from HIV-associated cryptococcal meningitis remains high (13–33%), even in developed countries, because of the inadequacy of current antifungal drugs and combinations, and the complication of raised intracranial pressure.[2,7,8]In the cases presented, the findings were so non-specific that the diagnosis was highly dependent on the CSF findings. Based on the characteristics of the presenting signs and symptoms, Cryptococcal meningitis should always be included in the differential diagnosis of chronic or subacute meningoencephalitis, since clinical features are not specific.
Cryptococcus Meningitis, in the Patients with Human immunodeficiency Virus Infection
International Journal of Pharmaceutical Science Invention, 2014
AIDS have given more importance to cryptococcosis,which was discovered a century ago.Cryptococcus neoformans is the most frequent cause of meningitis in HIV infected patients. Cryptococcus can infect any organ in the human body, the frequent sites are lung,CNS,skin,eye and prostrate The impact of capsular polysaccharide,melanin and ability to grow at higher temperature, in host immunity can be profound at pathophysiologic levels.Cryptococcal meningitis presentation in AIDS patients may be very subtle, with headache,fever,and lethargy. Meningeal signs occurs in some patients, photophobia and cranial nerve palsies are often absent, most patients have CD4 T-cell lower than 50 cells/µl.African patients have higher rate of neurologic compromise. Strong cellular immune response producing granulomatous inflammation is essential for containment of infection. Pathophysiology of cryptococcosis is similar to reactivation of tuberculosis, and histoplasmosis.Diagnostic methods include, direct microscopic examination by India ink mixing of biologic fluids, detection of polysaccharide antigen and a positive blood culture. Treatment of choice in AIDS patients with cryptococcal meningitis with amphotericin B with flucocytosine or fluconazole for 4 to 6 weeks Monotherapy cannot be recommended for the treatment of this infection.