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Pennisi MG, Hartmann K, Lloret A, Ferrer L, Addie D, Belák S, Boucraut-Baralon C, Egberink H, Frymus T, Gruffydd-Jones T, Hosie MJ, Lutz H, Marsilio F, Möstl K, Radford AD, Thiry E, Truyen U, Horzinek MC. Cryptococcosis in cats: ABCD guidelines on prevention and management. J Feline Med Surg 2014; 15:611-8. [PMID: 23813826 DOI: 10.1177/1098612x13489224] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OVERVIEW Cryptococcosis is worldwide the most common systemic fungal disease in cats; it is caused by the Cryptococcus neoformans- Cryptococcus gattii species complex, which includes eight genotypes and some subtypes (strains) with varying geographical distribution, pathogenicity and antimicrobial susceptibility. Cats acquire the infection from a contaminated environment. The prognosis is favourable in most cases, provided a diagnosis is obtained sufficiently early and prolonged treatment is maintained. INFECTION Basidiospores are the infectious propagules of Cryptococcus species as they penetrate the respiratory system and induce primary infection. Asymptomatic colonisation of the respiratory tract is more common than clinical disease. Avian guanos, particularly pigeon droppings, offer favourable conditions for the reproduction of C neoformans. Both Cryptococcus species are associated with decaying vegetation. DISEASE SIGNS Cryptococcosis caused by C neoformans or C gattii is indistinguishable clinically. The disease can present in nasal, central nervous system (which can derive from the nasal form or occur independently), cutaneous and systemic forms. DIAGNOSIS An easy and reliable test for cryptococcosis diagnosis is antigen detection in body fluids. Only isolation and polymerase chain reaction allow identification of the species genotype. DISEASE MANAGEMENT Amphotericin B, ketoconazole, fluconazole and itraconazole have all been used to treat cats. Surgical excision of any nodules in the skin, nasal or oral mucosa assists recovery. Continued treatment is recommended until the antigen test is negative. PREVENTION Efficient preventive measures have not been demonstrated. Vaccines are not available.
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Stress signaling pathways for the pathogenicity of Cryptococcus. EUKARYOTIC CELL 2013; 12:1564-77. [PMID: 24078305 DOI: 10.1128/ec.00218-13] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Sensing, responding, and adapting to the surrounding environment are crucial for all living organisms to survive, proliferate, and differentiate in their biological niches. This ability is also essential for Cryptococcus neoformans and its sibling species Cryptococcus gattii, as these pathogens have saprobic and parasitic life cycles in natural and animal host environments. The ability of Cryptococcus to cause fatal meningoencephalitis is highly related to its capability to remodel and optimize its metabolic and physiological status according to external cues. These cues act through multiple stress signaling pathways through a panoply of signaling components, including receptors/sensors, small GTPases, secondary messengers, kinases, transcription factors, and other miscellaneous adaptors or regulators. In this minireview, we summarize and highlight the importance of several stress signaling pathways that influence the pathogenicity of Cryptococcus and discuss future challenges in these areas.
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Cazzini P, Camus MS, Garner BC. Pathology in practice. Cryptococcal osteomyelitis in a dog. J Am Vet Med Assoc 2013; 242:1079-81. [PMID: 23547670 DOI: 10.2460/javma.242.8.1079] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Paola Cazzini
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA. )
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Vorathavorn VI, Sykes JE, Feldman DG. Cryptococcosis as an emerging systemic mycosis in dogs. J Vet Emerg Crit Care (San Antonio) 2013; 23:489-97. [PMID: 23981166 DOI: 10.1111/vec.12087] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 07/17/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To review the etiology, pathogenesis, and clinical presentations of canine cryptococcosis that are of relevance to veterinary emergency and critical care veterinarians. Diagnosis, treatment, and public health considerations of the disease will also be discussed. ETIOLOGY Cryptococcosis is a multisystemic disease of dogs, with a predilection for the CNS, caused by encapsulated yeast species of the genus Cryptococcus. The 2 main pathogenic species are Cryptococcus neoformans and Cryptococcus gattii (previously known as C. neoformans var. gattii). Cryptococcosis is an emerging disease in North America, with C. gattii gaining prominence as a cause of serious veterinary and human disease. DIAGNOSIS Definitive diagnosis is made by serologic (antigen) testing, culture, and identification of the organism using light microscopy. False negatives and false positives, while uncommon, can occur in dogs using commercially available antigen tests. Cytological examination demonstrates the organism in a majority of cases, although culture is more sensitive. Specific media are required to differentiate between C. neoformans and C. gattii. THERAPY The most commonly used antifungal drugs to treat canine cryptococcosis are azole antifungals and amphotericin B. Some strains of Cryptococcus are resistant to antifungal drugs, especially fluconazole. Cautious use of glucocorticoids in critically affected dogs with CNS presentations can improve outcome. PROGNOSIS Prognosis is variable and depends on the severity of disease, underlying host immunocompetence, and financial constraints of the owner. Altered mental status in dogs with CNS cryptococcosis is a negative prognostic indicator.
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Berthiaume DR, Kline KL. What is your neurologic diagnosis? C gattii infection. J Am Vet Med Assoc 2013; 241:1437-9. [PMID: 23176232 DOI: 10.2460/javma.241.11.1437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Devin R Berthiaume
- VCA Veterinary Specialty Center of Seattle, 20115 44th Ave W, Lynnwood, WA 98036, USA.
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Reed N, Gunn-Moore D. Nasopharyngeal disease in cats: 2. Specific conditions and their management. J Feline Med Surg 2012; 14:317-26. [PMID: 22511474 DOI: 10.1177/1098612x12444998] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PRACTICAL RELEVANCE Nasopharyngeal disease is a common presenting problem in feline medicine. CLINICAL CHALLENGES The management of feline nasopharyngeal disease can be challenging at a number of levels. In many cases, a specific diagnosis may remain elusive. Some conditions may not be curable so owners need to understand the requirement for long-term management. In addition, treatment may be compromised by poor patient compliance. AUDIENCE This review, which is directed at any clinicians involved in the management of cats with nasopharyngeal disease, discusses acute rhinitis (cat 'flu) and a variety of conditions causing chronic rhinosinusitis/chronic nasopharyngeal disease. The intention is to assist treatment decision making by reviewing the most appropriate therapies from the options available for these patients. EVIDENCE BASE The information presented in this article is based on peer-reviewed publications and the clinical experience of the authors.
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Affiliation(s)
- Nicki Reed
- Royal (Dick) School of Veterinary Studies, Division of Veterinary Clinical Sciences, University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG, Scotland, UK.
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Springer DJ, Phadke S, Billmyre B, Heitman J. Cryptococcus gattii, no longer an accidental pathogen? CURRENT FUNGAL INFECTION REPORTS 2012; 6:245-256. [PMID: 23243480 DOI: 10.1007/s12281-012-0111-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Cryptococcus gattii is an environmentally occurring pathogen that is responsible for causing cryptococcosis marked by pneumonia and meningoencephalitis in humans and animals. C. gattii can form long-term associations with trees and soil resulting in the production of infectious propagules (spores and desiccated yeast). The ever expanding reports of clinical and environmental isolation of C. gattii in temperate climates strongly imply C. gattii occurs world-wide. The key ability of yeast and spores to enter, survive, multiply, and exit host cells and to infect immunocompetent hosts distinguishes C. gattii as a primary pathogen and suggest evolution of C. gattii pathogenesis as a result of interaction with plants and other organisms in its environmental niche. Here we summarize the historical literature on C. gattii and recent literature supporting the world-wide occurrence of the primary pathogen C. gattii.
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Affiliation(s)
- Deborah J Springer
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, North Carolina, United States of America
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Cordeiro RDA, Nogueira GC, Brilhante RSN, Teixeira CEC, Mourão CI, Castelo-Branco DDSCM, Paiva MDAN, Ribeiro JF, Monteiro AJ, Sidrim JJC, Rocha MFG. Farnesol inhibits in vitro growth of the Cryptococcus neoformans species complex with no significant changes in virulence-related exoenzymes. Vet Microbiol 2012; 159:375-80. [DOI: 10.1016/j.vetmic.2012.04.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2011] [Revised: 04/04/2012] [Accepted: 04/05/2012] [Indexed: 10/28/2022]
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Magalhães G, Saut JE, Beninati T, Medeiros A, Queiroz G, Tsuruta S, Krockenberger M, Headley S. Cerebral Cryptococcomas in a Cow. J Comp Pathol 2012; 147:106-10. [PMID: 22520822 DOI: 10.1016/j.jcpa.2012.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 12/09/2011] [Accepted: 01/02/2012] [Indexed: 10/28/2022]
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Matos CS, de Souza Andrade A, Oliveira NS, Barros TF. Microbiological characteristics of clinical isolates of Cryptococcus spp. in Bahia, Brazil: molecular types and antifungal susceptibilities. Eur J Clin Microbiol Infect Dis 2012; 31:1647-52. [PMID: 22278291 PMCID: PMC3364408 DOI: 10.1007/s10096-011-1488-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 11/05/2011] [Indexed: 12/24/2022]
Abstract
To determine the profiles of susceptibility to antifungal and the genotypes of clinical isolates of Cryptococcus in Bahia, Brazil, 62 isolates were collected from cases of meningitis in the period from 2006 to 2010. Their susceptibilities to fluconazole, itraconazole, amphotericin B and 5-flucytosine were determined by the broth microdilution technique described by the Clinical and Laboratory Standards Institute and genotyping of the URA5 gene was accomplished by restriction fragment length polymorphism. C. neoformans accounted for 79% of the identified yeast and C. gattii represented the remaining 21%. Evaluation of the genotypes determined that 100% of the C. gattii isolates belong to the VGII genotype, and 98% of the C. neoformans isolates belong to the VNI genotype. Determination of susceptibility revealed isolates resistant to fluconazole (4.8%), 5-flucytosine (1.6%) and amphotericin B (3.2%); the stratification of sensitivity results for each species showed significant differences in susceptibility to azoles. This study is the first to describe the susceptibility profiles of molecular and clinical isolates of Cryptococcus in Bahia, Brazil. The high percentage of C. gattii isolates belonging to the VGII genotype and its lower susceptibility to antifungal agents highlight the importance of knowing which species are involved in cryptococcal infections in northeastern Brazil.
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Affiliation(s)
- C. S. Matos
- Graduate Program in Pharmacy, Faculty of Pharmacy, UFBA, Salvador, Brazil
| | - A. de Souza Andrade
- Program for Scientific Initiation, Faculty of Pharmacy, UFBA, Salvador, Brazil
| | | | - T. F. Barros
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, UFBA, Salvador, Brazil
- College of Pharmacy, Federal University of Bahia, Street Barão de Jeremoabo, University Campus of Ondina, Ondina, Salvador, Bahia Brazil CEP 40170-290
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Crestani J, Carvalho PC, Han X, Seixas A, Broetto L, Fischer JDSDG, Staats CC, Schrank A, Yates JR, Vainstein MH. Proteomic profiling of the influence of iron availability on Cryptococcus gattii. J Proteome Res 2011; 11:189-205. [PMID: 21970549 DOI: 10.1021/pr2005296] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Iron is essential and ubiquitous in living organisms. The competition for this micronutrient between the host and its pathogens has been related to disease establishment. Cryptococcus gattii is an encapsulated yeast that causes cryptococcosis mainly in immunocompetent individuals. In this study, we analyzed the proteomic profile of the C. gattii R265 Vancouver Island isolate under iron-depleted and -repleted conditions by multidimensional protein identification technology (MudPIT) and by 2D-GE. Proteins and key mechanisms affected by alteration of iron levels such as capsule production, cAMP-signaling pathway, response to stress, and metabolic pathways related to mitochondrial function were identified. Our results also show both proteomic methodologies employed to be complementary.
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Affiliation(s)
- Juliana Crestani
- Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves 9500, 43421, Caixa Postal 15005, Porto Alegre, RS 91501-970, Brazil
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Kano R, Ishida R, Nakane S, Sekiguchi M, Hasegawa A, Kamata H. The first reported case of canine subcutaneous Cryptococcus flavescens infection. Mycopathologia 2011; 173:179-82. [PMID: 21964623 DOI: 10.1007/s11046-011-9479-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 09/05/2011] [Indexed: 11/28/2022]
Abstract
This report describes the first documented case of subcutaneous infection due to Cryptococcus flavescens in a dog. The chief symptoms of the patient dog were abscessed lesions on the dorsal muzzle, right eyelid, and lower jaw. Biopsy specimens from the lesions on the dorsal muzzle and lower jaw showed pyogranulomatous inflammation with numerous yeast cells. The patient dog was diagnosed with a subcutaneous fungal infection and orally received 5 mg/kg itraconazole once a day for 2 months, the abscesses disappeared. After 1 month at the end of treatment, the skin lesions did not redevelop. Isolates from the biopsy specimens were identified as C. flavescens by molecular analysis as well as morphologic and biochemical examination, indicating that C. flavescens is a potential canine pathogen.
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Affiliation(s)
- Rui Kano
- Department of Pathobiology, Nihon University School of Veterinary Medicine, Fujisawa, Kanagawa, Japan.
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Byrnes EJ, Bartlett KH, Perfect JR, Heitman J. Cryptococcus gattii: an emerging fungal pathogen infecting humans and animals. Microbes Infect 2011; 13:895-907. [PMID: 21684347 PMCID: PMC3318971 DOI: 10.1016/j.micinf.2011.05.009] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Revised: 05/19/2011] [Accepted: 05/20/2011] [Indexed: 01/01/2023]
Abstract
Infectious fungi are among a broad group of microbial pathogens that has and continues to emerge concomitantly due to the global AIDS pandemic as well as an overall increase of patients with compromised immune systems. In addition, many pathogens have been emerging and re-emerging, causing disease in both individuals who have an identifiable immune defect and those who do not. The fungal pathogen Cryptococcus gattii can infect individuals with and without an identifiable immune defect, with a broad geographic range including both endemic areas and emerging outbreak regions. Infections in patients and animals can be severe and often fatal if untreated. We review the molecular epidemiology, population structure, clinical manifestations, and ecological niche of this emerging pathogen.
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Affiliation(s)
- Edmond J. Byrnes
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, USA
| | - Karen H. Bartlett
- School of Environmental Health, University of British Columbia, Vancouver, BC, Canada
| | - John R. Perfect
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Joseph Heitman
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, USA
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
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A decade of experience: Cryptococcus gattii in British Columbia. Mycopathologia 2011; 173:311-9. [PMID: 21960040 DOI: 10.1007/s11046-011-9475-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 09/02/2011] [Indexed: 12/31/2022]
Abstract
It has been over a decade since Cryptococcus gattii was first recognized as the causative organism of an outbreak of cryptococcosis on Vancouver Island, British Columbia. A number of novel observations have been associated with the study of this emergent pathogen. A novel genotype of C. gattii, VGIIa was described as the major genotype associated with clinical disease. Minor genotypes, VGIIb and VGI, are also responsible for disease in British Columbians, in both human and animal populations. The clinical major genotype VGIIa and minor genotype VGIIb are identical to C. gattii isolated from the environment of Vancouver Island. There is more heterogeneity in VGI, and a clear association with the environment is not apparent. Between 1999 and 2010, there have been 281 cases of C. gattii cryptococcosis. Risk factors for infection are reported to be age greater than 50 years, history of smoking, corticosteroid use, HIV infection, and history of cancer or chronic lung disease. The major C. gattii genotype VGIIa is as virulent in mice as the model Cryptococcus, H99 C. neoformans, although the outbreak strain produces a less protective inflammatory response in C57BL/6 mice. The minor genotype VGIIb is significantly less virulent in mouse models. Cryptococcus gattii is found associated with native trees and soil on Vancouver Island. Transiently positive isolations have been made from air and water. An ecological niche for this organism is associated within a limited biogeoclimatic zone characterized by daily average winter temperatures above freezing.
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Krockenberger MB, Lester SJ. Cryptococcosis--clinical advice on an emerging global concern. J Feline Med Surg 2011; 13:158-60. [PMID: 21338939 DOI: 10.1016/j.jfms.2011.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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