: immunological and microbiological study in a patient with neurocryptococcosis Open Access

Abstract

Introduction:

Cryptococcal meningitis is a disease that remains a significant cause of morbidity and mortality. This report describes the importance of conducting a detailed clinical investigation and the treatment challenges in cases of meningitis caused by . In recent years this species has received considerable interest due to its increased emergence and virulence.

Case presentation:

A patient with apparent good health (a fitness practitioner) showed symptoms including intermittent headache that became more intense and frequent when he began experiencing nausea, vomiting, dizziness and temporal headache without nuchal rigidity. The patient had human immunodeficiency virus-negative serology and had no chronic disease. Analysis of cerebrospinal fluid was performed and cryptococcal meningitis was diagnosed. Immunophenotyping by flow cytometry evidenced the presence of an anomalous lymphoid population. RFLP analysis of the gene indicated genotype VGII and considerable virulence was observed for the isolated strain.

Conclusion:

This case suggests the importance of a detailed investigation in patients who apparently have a competent immune system with meningitis caused by spp., particularly

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2015-10-09
2024-03-29
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References

  1. Barreto de Oliveira M. T., Boekhout T., Theelen B., Hagen F., Baroni F. A., Lazera M. S., Lengeler K. B., Heitman J., Rivera I. N., Paula C. R. 2004; Cryptococcus neoformans shows a remarkable genotypic diversity in Brazil. J Clin Microbiol 42:1356–1359 [View Article][PubMed]
    [Google Scholar]
  2. Bovers M., Hagen F., Kuramae E. E., Hoogveld H. L., Dromer F., St-Germain G., Boekhout T. 2008; AIDS patient death caused by novel Cryptococcus neoformans × C. gattii hybrid. Emerg Infect Dis 14:1105–1108 [View Article][PubMed]
    [Google Scholar]
  3. Chaturvedi V., Chaturvedi S. 2011; Cryptococcus gattii: a resurgent fungal pathogen. Trends Microbiol 19:564–571 [View Article][PubMed]
    [Google Scholar]
  4. Chen S. C., Meyer W., Sorrell T. C. 2014; Cryptococcus gattii infections. Clin Microbiol Rev 27:980–1024 [View Article][PubMed]
    [Google Scholar]
  5. CLSI 2007 Clinical Flow Cytometric Analysis of Neoplastic Hematolymphoid Cells Approved guideline Document H43-A2, 2nd edn. Wayne, PA: Clinical and Laboratory Standards Institute;
    [Google Scholar]
  6. Dhodapkar M. V., Li C. Y., Lust J. A., Tefferi A., Phyliky R. L. 1994; Clinical spectrum of clonal proliferations of T-large granular lymphocytes: a T-cell clonopathy of undetermined significance?. Blood 84:1620–1627[PubMed]
    [Google Scholar]
  7. Favalessa O. C., Lázera M. S., Wanke B., Trilles L., Takahara D. T., Tadano T., Dias L. B., Vieira A. C., Novack G. V., Hahn R. C. 2014; Fatal Cryptococcus gattii genotype AFLP6/VGII infection in a HIV-negative patient: case report and a literature review. Mycoses 57:639–643 [View Article][PubMed]
    [Google Scholar]
  8. Gullo F. P., Rossi S. A., Sardi J. C., Teodoro V. L., Mendes-Giannini M. J., Fusco-Almeida A. M. 2013; Cryptococcosis: epidemiology, fungal resistance, and new alternatives for treatment. Eur J Clin Microbiol Infect Dis 32:1377–1391 [View Article][PubMed]
    [Google Scholar]
  9. Hagen F., Illnait-Zaragozi M. T., Bartlett K. H., Swinne D., Geertsen E., Klaassen C. H., Boekhout T., Meis J. F. 2010; In vitro antifungal susceptibilities and amplified fragment length polymorphism genotyping of a worldwide collection of 350 clinical, veterinary, and environmental Cryptococcus gattii isolates. Antimicrob Agents Chemother 54:5139–5145 [View Article][PubMed]
    [Google Scholar]
  10. Howard M. T., Bejanyan N., Maciejewski J. P., Hsi E. D. 2010; T/NK large granular lymphocyte leukemia and coexisting monoclonal B-cell lymphocytosis-like proliferations. An unrecognized and frequent association. Am J Clin Pathol 133:936–941 [View Article][PubMed]
    [Google Scholar]
  11. Jesus M. S., Rodrigues W. C., Barbosa G., Trilles L., Wanke B., Lazéra M. S., Silva M. 2012; Cryptococcus neoformans carried by Odontomachus bauri ants. Mem Inst Oswaldo Cruz 107:466–469 [View Article][PubMed]
    [Google Scholar]
  12. Kurtzman C. P., Fell J. W., Boekhout T. 2011 The Yeasts: A Taxonomic Study, 5th edn. Amsterdam: Elsevier;
    [Google Scholar]
  13. Li M., Liao Y., Chen M., Pan W., Weng L. 2012; Antifungal susceptibilities of Cryptococcus species complex isolates from AIDS and non-AIDS patients in Southeast China. Braz J Infect Dis 16:175–179 [View Article][PubMed]
    [Google Scholar]
  14. Lizarazo J., Escandón P., Agudelo C. I., Firacative C., Meyer W., Castañeda E. 2014; Retrospective study of the epidemiology and clinical manifestations of Cryptococcus gattii infections in Colombia from 1997-2011. PLoS Negl Trop Dis 8:e3272 [View Article][PubMed]
    [Google Scholar]
  15. Meya D., Rajasingham R., Nalintya E., Tenforde M., Jarvis J. N. 2015; Preventing cryptococcosis - shifting the paradigm in the era of highly active antiretroviral therapy. Curr Trop Med Rep 2:81–89 [View Article][PubMed]
    [Google Scholar]
  16. Meyer W., Castañeda A., Jackson S., Huynh M., Castañeda E., IberoAmerican Cryptococcal Study Group. 2003; Molecular typing of IberoAmerican Cryptococcus neoformans isolates. Emerg Infect Dis 9:189–195 [View Article][PubMed]
    [Google Scholar]
  17. Morales B. P., Trilles L., Bertho A. L., Junior I. N., de Oliveira R. V., Wanke B., Lazéra M. S. 2015; In vitro susceptibility testing of amphotericin B for Cryptococcus neoformans variety grubii AFLP1/VNI and Cryptococcus gattii AFLP6/VGII by CLSI and flow cytometry. Mycoses 58:273–279 [View Article][PubMed]
    [Google Scholar]
  18. Perfect J. R., Dismukes W. E., Dromer F., Goldman D. L., Graybill J. R., Hamill R. J., Harrison T. S., Larsen R. A., Lortholary O., other authors. 2010; Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis 50:291–322 [View Article][PubMed]
    [Google Scholar]
  19. Prado M., Silva M. B., Laurenti R., Travassos L. R., Taborda C. P. 2009; Mortality due to systemic mycoses as a primary cause of death or in association with AIDS in Brazil: a review from 1996 to 2006. Mem Inst Oswaldo Cruz 104:513–521 [View Article][PubMed]
    [Google Scholar]
  20. Price M. F., Wilkinson I. D., Gentry L. O. 1982; Plate method for detection of phospholipase activity in Candida albicans. Sabouraudia 20:7–14 [View Article][PubMed]
    [Google Scholar]
  21. Randhawa H. S., Kowshik T., Chowdhary A., Preeti Sinha K., Khan Z. U., Sun S., Xu J. 2008; The expanding host tree species spectrum of Cryptococcus gattii and Cryptococcus neoformans and their isolations from surrounding soil in India. Med Mycol 46:823–833 [View Article][PubMed]
    [Google Scholar]
  22. Rüchel R., Tegeler R., Trost M. 1982; A comparison of secretory proteinases from different strains of Candida albicans. Sabouraudia 20:233–244 [View Article][PubMed]
    [Google Scholar]
  23. Saijo T., Chen J., Chen S. C., Rosen L. B., Yi J., Sorrell T. C., Bennett J. E., Holland S. M., Browne S. K., Kwon-Chung K. J. 2014; Anti-granulocyte-macrophage colony-stimulating factor autoantibodies are a risk factor for central nervous system infection by Cryptococcus gattii in otherwise immunocompetent patients. MBio 5:e00912–e00914 [View Article][PubMed]
    [Google Scholar]
  24. Wood B. L., Arroz M., Barnett D., DiGiuseppe J., Greig B., Kussick S. J., Oldaker T., Shenkin M., Stone E., Wallace P. 2007; 2006 Bethesda International Consensus recommendations on the immunophenotypic analysis of hematolymphoid neoplasia by flow cytometry: optimal reagents and reporting for the flow cytometric diagnosis of hematopoietic neoplasia. Cytometry B Clin Cytom 72B:Suppl 1S14–S22 [View Article][PubMed]
    [Google Scholar]
  25. Zhang R., Shah M. V., Loughran T. P. Jr 2010; The root of many evils: indolent large granular lymphocyte leukaemia and associated disorders. Hematol Oncol 28:105–117[PubMed]
    [Google Scholar]
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