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Emergence of amphotericin B-resistant Cryptococcus laurentii meningoencephalitis shortly after treatment for Cryptococcus neoformans meningitis in a patient with AIDS.

A unique occurrence of two subsequent episodes of HIV-associated Cryptococcus neoformans followed by C. laurentii meningoencephalitis (successfully cured with fluconazole after demonstrated amphotericin B resistance) is presented and discussed. The available literature reported only two cases of HIV...

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Published in:AIDS Patient Care & STDs Vol. 20; no. 4; pp. 227 - 233
Main Authors: Manfredi R, Fulgaro C, Sabbatani S, Legnani G, Fasulo G
Format: case study Journal Article
Published: Mary Ann Liebert, Inc. Apr2006
Online Access:View this record in EBSCOhost
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        10872914
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      jtl: AIDS Patient Care & STDs
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      dt: Apr2006
      vid: 20
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      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        2009178744
        10.1089/apc.2006.20.227
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        atl: Emergence of amphotericin B-resistant Cryptococcus laurentii meningoencephalitis shortly after treatment for Cryptococcus neoformans meningitis in a patient with AIDS.
      aug:
        au:
          Manfredi R
          Fulgaro C
          Sabbatani S
          Legnani G
          Fasulo G
        affil: Department of Clinical and Experimental Medicine, Division of Infectious Diseases, University of Bologna Alma Mater Studiorum, S. Orsola Hospital, Bologna, Italy. manfredi@med.unibo.it
      sug:
        subj:
          AIDS-Related Opportunistic Infections
          Amphotericin B
          Cryptococcus
          Drug Resistance, Microbial
          Meningitis
          Mycoses
          Adult
          HIV-Positive Persons
          Persons Who Use Intravenous Drugs
          Male
          Meningitis Drug Therapy
          Meningoencephalitis Drug Therapy
          Mycoses Diagnosis
          Adult: 19-44 years
          Male
      ab: A unique occurrence of two subsequent episodes of HIV-associated Cryptococcus neoformans followed by C. laurentii meningoencephalitis (successfully cured with fluconazole after demonstrated amphotericin B resistance) is presented and discussed. The available literature reported only two cases of HIV-associated C. laurentii infection to date, while a concurrent infection by C. neoformans and C. laurentii has been reported only once in a patient without HIV disease. The absence of prior descriptions of documented central nervous system infection by C. laurentii in non-HIV-infected patients is emphasized as well as the unpredictable in vitro and in vivo antifungal susceptibility of this non-neoformans Cryptococcus spp., and its apparent prevalence in hospitalized patients who received prior antifungal treatments. All epidemiologic, diagnostic, clinical, and therapeutic implications are discussed on the basis of the evolving characteristics of opportunism in the era of highly active antiretroviral therapy (HAART).
      pubtype: Academic Journal
      doctype:
        case study
        Journal Article
      ougenre: Article
    language: English
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