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Cryptococcus Neoformans

Cutaneous Cryptococcus Neoformans


Presentation

  • Clinical presentations also depend on the characteristics of the immunological competency of the patients. In general, it is a systemic fungal infection with its origin as the inhalation of C. neoformans, initially affecting the lungs.[ncbi.nlm.nih.gov]
  • .• Present as discrete nodules - Cryptococcoma. 12 DR.T.V.RAO MD 13.[slideshare.net]
  • Current knowledge on the epidemiology and clinical presentation of C. neoformans infection is clearly greater than that related to C. gattii.[nature.com]
  • The sequences presented in this article have been submitted to the National Center for Biotechnology Information Gene Expression Omnibus under accession number GSE126977. The online version of this article contains supplemental material.[jimmunol.org]
  • […] or geography (present in the two compared clades but no others).[genetics.org]
Pathologist
  • Following the analysis of the CDA samples, a panel composed of a pathologist, a microbiologist, and a clinician with expertise in infectious diseases and epidemiology evaluated all the data (including the clinical information) and assigned the final cause[nature.com]
Back Pain
  • Two months before admission a non-radiating lower back pain evolved which was independent of movement. Because of progressing gait disturbances and a delayed micturition the patient was transferred to our hospital.[jnnp.bmj.com]
Dermatitis
  • Except for a history of atopic eczematous dermatitis the patient had never experienced illness. She had travelled outside Europe to the United states between 1993 and 1996 (East coast, Middle West, Florida), and to Tunesia in 1995.[jnnp.bmj.com]
Night Sweats
  • There were no headaches, nausea, fever, weight loss, night sweat, skin alterations, or icterus. Except for a history of atopic eczematous dermatitis the patient had never experienced illness.[jnnp.bmj.com]
Tingling
  • About 3 months before admission she developed a tingling sensention in her right foot and shin which gradually deteriorated before she felt a numbness in her left foot.[jnnp.bmj.com]
Clonus
  • Ankle clonus could be elicited on both sides, plantar responses were flexor. There was a diffuse decrease in sensation below the knees to light touch, pinprick, deep pain, and vibration.[jnnp.bmj.com]

Workup

Toxoplasma Gondii
  • HIV, viral hepatitis, tuberculosis, malaria) and bacterial/fungal culture of autopsy samples, targeted screening depending on the patient’s condition (i.e. screening for Cryptococcus, Toxoplasma gondii and Pneumocystis jirovecii in HIV-infected cases)[nature.com]
Cryptococcus Antigen
  • Plasma and CSF samples were tested by both real time PCR and the Cryptococcus antigen (CrAg) lateral flow assay (LFA) (IMMY Inc., Norman, Oklahoma).[nature.com]

Treatment

  • […] of antiretroviral therapy (ART), despite microbiological evidence of effective antifungal treatment.[ 8, 9 ] Footnotes Source of Support: Nil.[ncbi.nlm.nih.gov]
  • TREATMENT• Immune competent - Fuconazole,Itraconazole• Immune Deficient – Amphotericin B Flu cytosine AIDS patients are not totally cured, Relapses are frequent with fatal outcome. Rapid resistance with Fluconazole.[slideshare.net]
  • Nevertheless, we would not recommend decompressive laminectomy as first line treatment because of the individuality of our case.[jnnp.bmj.com]
  • It may also be that DNA is detected from fungal cells which are not viable and remained in liquor after treatment, since these samples were from patients who were under treatment.[mycology.imedpub.com]
  • "Cryptococcal meningitis treatment strategies in resource-limited settings: a cost-effectiveness analysis". PLoS Med. 9 (9): e1001316. doi : 10.1371/journal.pmed.1001316. PMC 3463510. PMID 23055838.[en.wikipedia.org]

Prognosis

  • High antigen securities generally correlate with disease severity and likewise a decrease corresponds to a good prognosis.[mycology.imedpub.com]

Epidemiology

  • C. neoformans is a form of yeast with biochemical, antigenic, and epidemiological differences. There are two known varieties.[ncbi.nlm.nih.gov]
  • Recent reports on outbreaks of cryptococcosis in goats due to C neoformans var gattii in Spain 19 will give new epidemiological insights.[jnnp.bmj.com]
  • EPIDEMIOLOGY• HIV• Lymphoproliferative disorders• Sarcoidosis• Corticosteroids• Hyper IgM or IgE syndrome• Monoclonal antibodies (infliximab)• SLE• CD4 T-cell lymphoma (idiopathic)• Diabetes• Organ transplant• Peritoneal dialysis• Cirrhosis• 20% without[slideshare.net]
  • Current knowledge on the epidemiology and clinical presentation of C. neoformans infection is clearly greater than that related to C. gattii.[nature.com]
  • BrandaoAfm, Lima As, Rodrigues Abn, LobatoFjc, Santos I (2002) Cryptococcalmeningoencephalitis : clinical study of epidemiological 59.[mycology.imedpub.com]
Sex distribution
Age distribution

Prevention

  • PREVENTION• Fluconazole prophylaxis• Active immunization- cryptococcal GXM-tetanus toxoid conjugate vaccine- in animal models, no human trials• Monoclonal antibodies- would require repeated injections• Avoid high risk environments 24.[slideshare.net]
  • Taking this medication helps prevent relapses.[healthline.com]
  • The World Health Organization has also developed guidelines for the diagnosis, prevention, and management of cryptococcal disease in HIV-infected adults, adolescents, and children External, with a focus on resource-limited settings.[cdc.gov]
  • […] and low iron, among others, the cells produce a characteristic polysaccharide capsule. [5] The recognition of C. neoformans in Gram-stained smears of purulent exudates may be hampered by the presence of the large gelatinous capsule which apparently prevents[en.wikipedia.org]

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