Central Nervous System Cryptococcal Infections in Non-HIV Infected Patients

Journal of Fungi
Justin BeardsleySharon C-A Chen

Abstract

Central nervous system (CNS) cryptococcosis in non-HIV infected patients affects solid organ transplant (SOT) recipients, patients with malignancy, rheumatic disorders, other immunosuppressive conditions and immunocompetent hosts. More recently described risks include the use of newer biologicals and recreational intravenous drug use. Disease is caused by Cryptococcus neoformans and Cryptococcus gattii species complex; C. gattii is endemic in several geographic regions and has caused outbreaks in North America. Major virulence determinants are the polysaccharide capsule, melanin and several 'invasins'. Cryptococcal plb1, laccase and urease are essential for dissemination from lung to CNS and crossing the blood-brain barrier. Meningo-encephalitis is common but intracerebral infection or hydrocephalus also occur, and are relatively frequent in C. gattii infection. Complications include neurologic deficits, raised intracranial pressure (ICP) and disseminated disease. Diagnosis relies on culture, phenotypic identification methods, and cryptococcal antigen detection. Molecular methods can assist. Preferred induction antifungal therapy is a lipid amphotericin B formulation (amphotericin B deoxycholate may be used in non-transplant pa...Continue Reading

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Citations

Jul 28, 2020·Journal of Fungi·Man Shun Fu, Rebecca A Drummond
Jan 30, 2020·Frontiers in Microbiology·Rocio Garcia-RubioNuria Trevijano-Contador
Jul 4, 2020·Indian Journal of Pediatrics·Gurdeep S DhooriaShruti Kakkar
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Sep 17, 2021·Scientific Reports·Israel Diniz-LimaCelio Geraldo Freire-de-Lima

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Methods Mentioned

BETA
X-ray
biopsy
bronchoalveolar lavage

Software Mentioned

RUO

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