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Cryptococcal Infection (cryptococcal + infection)
Selected AbstractsCryptococcal infection in sarcoidosisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 11 2002Khosrow Mehrany MD A 48-year-old man with a history of sarcoidosis was transferred to the Mayo Clinic for evaluation and management of progressive neurologic decline. Two years before admission, he was admitted to a local hospital with mental status changes accompanied by ataxia and severe headache. A diagnosis of pulmonary and central nervous system sarcoidosis was made based on computed tomography of the head, lumbar puncture, and chest radiography. A mediastinoscopy with lymph node biopsy exhibited noncaseating granulomas and negative stains for microorganisms. Prednisone therapy was initiated at 80 mg/day. Clinical improvement was apparent for 13 months during steroid therapy until the slow taper reached a dosage of 20 mg/day. At that time, the patient was readmitted to the local hospital with severe confusion and skin lesions. When intravenous methylprednisolone therapy for presumed central nervous system sarcoidosis did not improve the patient's mental status, he was transferred to the Mayo Clinic. Physical examination of the thighs revealed large, well-marginated, indurated, irregularly bordered, violaceous plaques and rare, umbilicated, satellite papules with central hemorrhagic crusts (Fig. 1A). Superficially ulcerated plaques with a similar appearance to the thigh lesions were coalescing around the lower legs (Fig. 1B). A skin biopsy specimen of the thigh demonstrated abundant numbers of encapsulated organisms and minimal inflammatory response (Fig. 2). Skin, blood, and cerebrospinal fluid cultures confirmed the presence of Cryptococcus neoformans. Amphotericin and flucytosine combination therapy was initiated, and steroid dosages were gradually tapered. A test for human immunodeficiency virus was negative. The patient was dismissed from hospital after a complicated 2-month course resulting in improved mental status but progression of the lower extremity ulcerations as a result of polymicrobial infection. Figure 1. (A) Violaceous plaque with satellite papules on thigh. (B) Ulcerating plaques coalescing around leg Figure 2. (A) Sparse inflammatory infiltrate and abundant encapsulated organisms (hematoxylin and eosin; × 20). (B) Cryptococcal organisms (Gomori's methenamine silver; × 40) [source] Granulomatous cryptococcal prostatitis diagnosed by transrectal biopsyINTERNATIONAL JOURNAL OF UROLOGY, Issue 5 2006ILL YOUNG SEO Abstract, Cryptococcal infection primarily involves the lung and is hematogenously spread to other organs. Sometimes it might affect the genitourinary tract, and rare cases have been reported involving the prostate without systemic infection. We report a case of granulomatous prostatitis as a result of Cryptococcus neoformans yeast in an immunocompromised patient with alcoholic liver cirrhosis, which was diagnosed by transrectal ultrasound guided biopsy and treated with antifungal medication. [source] Neutropenia alters lung cytokine production in mice and reduces their susceptibility to pulmonary cryptococcosisEUROPEAN JOURNAL OF IMMUNOLOGY, Issue 6 2003Abstract Neutrophils are generally considered to contribute to host defense through their potent microbicidal activity. However, there is accumulating evidence that neutrophils also have an important regulatory role in establishing the balance of Th1 and Th2 responses. This study investigated the role of neutrophils in defense against pulmonary Cryptococcus neoformans infection using neutrophil-depleted BALB/c mice generated by administering mAb RB6,8C5. Neutropenic mice with pulmonary infection survived significantly longer than control mice, but there was no difference between groups infected intravenously. On day,1 of infection, neutropenic mice had significantly smaller fungal burdens than control mice. On day,7, neutropenic mice had significantly higher lung concentrations of IL-10, TNF-,, IL-4, and IL-12 than control mice, but there was no difference in IFN-, and MCP-1 levels. Neutrophils influenced the outcome of cryptococcal infection in mice through mechanisms that did not involve a reduction in early fungal burden. The absence of neutrophils in lung tissue during the initial stages of infection appeared to alter the inflammatory response in a manner thatwas subsequently beneficial to the host. Higher levels of Th1- and Th2-associated cytokines in neutropenic mice could have simultaneously promoted a strong cellular response while reducing inflammatory damage to the lung. Our results support the emerging concept that neutrophils play an important function in modulating the development of the immune response. [source] Critical illness polyneuromyopathy in a patient with disseminated cryptococcal infectionJOURNAL OF HOSPITAL MEDICINE, Issue 2 2009Jenn-Yu Wu MD Abstract Critical illness polyneuromyopathy is frequent in patients in intensive care units. We report a case of critical illness polyneuromyopathy in a patient with disseminated cryptococcal infection in an intensive care unit. Journal of Hospital Medicine 2009;4:E3,E6. © 2009 Society of Hospital Medicine. [source] Cryptococcosis,a review of 13 autopsy cases from a 54-year period in a large hospital,APMIS, Issue 3 2007P. BENE From 1952 to 2005, 13 cases of cryptococcosis confirmed by postmortem examination were diagnosed in autopsy material from the University Hospital in Hradec Králové, the Czech Republic. Histologically, Cryptococcus was found in multiple organs (brain and spinal cord, lungs, lymph nodes, spleen, bone marrow, liver, kidneys and adrenal glands). The lungs and CNS were the organs most often involved. Only in two cases was the diagnosis of cryptococcal infection established during the patient's lifetime, in both presenting clinically as meningitis, with positive result of CSF cultivation. Data and issues of diagnostics and treatment of cryptococcosis are discussed. [source] | ||||||||||