Management of Cryptococcus gattii meningoencephalitis.
Cryptococcosis is a fungal disease caused by Cryptococcus neoformans and Cryptococcus gattii. By inhalation and subsequent pulmonary infection, it may disseminate to the CNS and cause meningitis or meningoencephalitis. Most cases occur in immunosuppressed hosts, including patients with HIV/AIDS, pat...
| Published in: | Lancet Infectious Diseases Vol. 15; no. 3; pp. 348 - 356 |
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| Main Authors: | , , , , , , , , , |
| Format: | case study review Journal Article |
| Published: |
Elsevier B.V.
Mar2015
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103792076&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103792076 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14733099 KIL jtl: Lancet Infectious Diseases issn: 14733099 maglogo: N pubinfo: dt: Mar2015 vid: 15 iid: 3 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 103792076 NLM25467646 2012984287 10.1016/S1473-3099(14)70945-4 NLM25467646 PMC4481715 103792076 ppf: 348 ppct: 8 formats: tig: atl: Management of Cryptococcus gattii meningoencephalitis. aug: au: Franco-Paredes, Carlos Womack, Tanea Bohlmeyer, Teri Sellers, Brenda Hays, Allison Patel, Kalpesh Lizarazo, Jairo Lockhart, Shawn R Siddiqui, Wajid Marr, Kieren A affil: Phoebe Putney Memorial Hospital, Albany, GA, USA; Hospital Infantil de Mexico, Federico Gomez, Mexico City, Mexico. Electronic address: carlos.franco.paredes@gmail.com. sug: subj: Cryptococcosis Diagnosis Cryptococcosis Therapy Cryptococcus Meningoencephalitis Diagnosis Meningoencephalitis Therapy Adolescence Antiinflammatory Agents Therapeutic Use Antifungal Agents Therapeutic Use Brain Pathology Brain Radiography Cryptococcosis Microbiology Cryptococcosis Pathology Female Intracranial Hypertension Therapy Magnetic Resonance Imaging Meningoencephalitis Microbiology Meningoencephalitis Pathology Microbiological Techniques Microscopy Adolescent: 13-18 years Female ab: Cryptococcosis is a fungal disease caused by Cryptococcus neoformans and Cryptococcus gattii. By inhalation and subsequent pulmonary infection, it may disseminate to the CNS and cause meningitis or meningoencephalitis. Most cases occur in immunosuppressed hosts, including patients with HIV/AIDS, patients receiving immunosuppressing drugs, and solid organ transplant recipients. However, cryptococcosis also occurs in individuals with apparently healthy immune systems. A growing number of cases are caused by C gattii, with infections occurring in both immunosuppressed and immunocompetent individuals. In the majority of documented cases, treatment of C gattii infection of the CNS requires aggressive management of raised intracranial pressure along with standard antifungal therapy. Early cerebrospinal fluid evacuation is often needed through placement of a percutaneous lumbar drain or ventriculostomy. Furthermore, pharmacological immunosuppression with a high dose of dexamethasone is sometimes needed to ameliorate a persistently increased inflammatory response and to reduce intracranial pressure. In this Grand Round, we present the case of an otherwise healthy adolescent female patient, who, despite aggressive management, succumbed to C gattii meningoencephalitis. We also present a review of the existing literature and discuss optimum clinical management of meningoencephalitis caused by C gattii. pubtype: Academic Journal doctype: case study review Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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