1
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Huo K, Gao J, Wang Y, Qin X, Ma X. Short segment myelitis as a dominant manifestation of cryptococcal infection: a case report. BMC Infect Dis 2024; 24:863. [PMID: 39187777 PMCID: PMC11346243 DOI: 10.1186/s12879-024-09756-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 08/14/2024] [Indexed: 08/28/2024] Open
Abstract
Cryptococcal infection of central nervous system commonly involves meningitis or meningoencephalitis, but rarely mimics inflammatory myelitis. We present short segment myelitis as a dominant manifestation caused by Cryptococcus neoformans in a patient with nephrotic syndrome under immunosuppressive therapy. This case report highlights Cryptococcus neoformans as a potential etiological factor for short segment myelitis in immunocompromised hosts.
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Affiliation(s)
- Kaikai Huo
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710043, China
| | - Jing Gao
- Department of Neurology, The First Affiliated Hospital Yulin Hospital of Xi'an Jiao Tong University, Yulin, 719000, China
| | - Yao Wang
- Department of Neurology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - Xing Qin
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, 710075, China.
| | - Xue Ma
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, 710075, China.
- Department of Neurology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China.
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2
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Liu J, Liu J, Yang L, Xu X, Bang-E Q, Jiang Y, Peng F. Review: The application of corticosteroids in cryptococcal meningitis. J Mycol Med 2023; 33:101364. [PMID: 36870302 DOI: 10.1016/j.mycmed.2023.101364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/30/2022] [Accepted: 02/21/2023] [Indexed: 03/05/2023]
Abstract
Cryptococcal meningitis (CM) is a serious disease with high morbidity and mortality. Although the patients who received corticosteroids were at high risk of having CM, corticosteroids also have been used as an adjunct to antifungal drugs for treating people with CM in some situations (such as immune reconstitution inflammatory syndrome, cerebral cyptococcoma, et al.). Here, we summarize the current knowledge on the application of the corticosteroids in CM, aiming to help clinicians to reasonably use corticosteroids in patients with CM.
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Affiliation(s)
- Junyu Liu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, PR China
| | - Jia Liu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, PR China
| | - Lu Yang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, PR China
| | - Xiaofeng Xu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, PR China
| | - Qin Bang-E
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, PR China
| | - Ying Jiang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, PR China.
| | - Fuhua Peng
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, PR China.
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3
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Cryptococcal Meningitis: A Rare Complication in HIV-Negative Patients with Nephrotic Syndrome in A Chinese Teaching Hospital. Mycopathologia 2020; 185:959-969. [PMID: 32789738 DOI: 10.1007/s11046-020-00482-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 08/04/2020] [Indexed: 10/20/2022]
Abstract
Cryptococcal meningitis (CM) is a rare complication in HIV-negative patients with nephrotic syndrome (NS), and knowledge about the clinical profile of NS with CM is limited. We performed a retrospective study of all patients with CM-NS admitted to the Jiangxi Chest Hospital (JCH) between 2011 and 2019 and systematically reviewed cases of CM-NS reported in the Chinese language. Among a total of 226 CM patients referred to the JCH, seven had NS (3.1%); these patients were combined with 22 CM-NS cases reported in the Chinese language for analysis. Headache, fever, nausea, and meningeal irritation were the most common initial symptoms, and the median time from symptom onset to CM diagnostic confirmation was 30 days. One patient initially tested negative for CM but was later confirmed to be positive. Among the 29 analysed patients, 41.4% (12/29) were misdiagnosed with other complications, including four patients from the JCH (4/7, 57.1%) and eight patients from published reports (8/22, 36.3%). The overall mortality rate was 17.2% (5/29); among these patients, 60% (3/5) were misdiagnosed. Induction treatment with amphotericin B plus 5-fluorocytosine (9/29) or amphotericin B plus fluconazole (7/29) successfully cleared the infection. Fluconazole may be a suitable alternative if 5-fluorocytosine is not readily available or not tolerated, and repetitive testing is important to reach a conclusive diagnosis in NS patients suspected of having CM.
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4
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Zhang Q, Li H, Zhang K, Arastehfar A, Daneshnia F, Fang W, He P, Kuang W, Jiang G, Chen M, Boekhout T, Li S, Jiang W, Liao W, Pan W. Lumbar drainage for the treatment of refractory intracranial hypertension in HIV-negative cryptococcal meningitis. Future Microbiol 2019; 14:859-866. [PMID: 31165635 DOI: 10.2217/fmb-2019-0084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Aim: This study aims to evaluate lumbar drainage (LD) for controlling refractory intracranial hypertension among non-HIV cryptococcal meningitis patients. Patients & methods: A case–control study was designed to compare LD (case) with repeated lumbar puncture (control). Results: Both LD and repeated lumbar puncture can efficiently control refractory intracranial hypertension. LD group showed better clinical symptom remission, such as lower rate of headache, vision disorders, signs of meningeal irritation and conscious disturbance, than control group. LD group was reported with higher intracranial pressure reduction (173.75 ± 17.72 mmH2O) than those among control group (113.50 ± 14.94 mmH2O; p < 0.05). Conclusion: LD is an effective and safe alternative to control refractory intracranial hypertension in HIV-negative cryptococcal meningitis patients.
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Affiliation(s)
- Qilong Zhang
- Department of Internal Neurology, Jiangxi Chest Hospital, Jiangxi 330000, PR China
| | - Hang Li
- Department of Internal Neurology, Jiangxi Chest Hospital, Jiangxi 330000, PR China
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
| | - Keming Zhang
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
| | - Amir Arastehfar
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Farnaz Daneshnia
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Wenjie Fang
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
| | - Peijuan He
- Department of Internal Neurology, Jiangxi Chest Hospital, Jiangxi 330000, PR China
| | - Weifeng Kuang
- Department of Internal Neurology, Jiangxi Chest Hospital, Jiangxi 330000, PR China
| | - Guoqiang Jiang
- Department of Internal Neurology, Jiangxi Chest Hospital, Jiangxi 330000, PR China
| | - Min Chen
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
| | - Teun Boekhout
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
- Institute of Biodiversity & Ecosystem Dynamics, University of Amsterdam, Amsterdam 1012 WX, The Netherlands
| | - Shuai Li
- Department of Clinical Laboratory, Yan'an People’s Hospital, Shanxi 716000, PR China
| | - Weiwei Jiang
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
| | - Wanqing Liao
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
| | - Weihua Pan
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
- Department of Dermatology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
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5
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Hua W, Vogan A, Xu J. Genotypic and Phenotypic Analyses of Two “Isogenic” Strains of the Human Fungal Pathogen Cryptococcus neoformans var. neoformans. Mycopathologia 2019; 184:195-212. [DOI: 10.1007/s11046-019-00328-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 03/09/2019] [Indexed: 12/21/2022]
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6
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A Comparison of the Clinical Characteristics and Outcomes of Cryptococcal Meningitis in HIV-negative Individuals With and Without Immunosuppression. Neurologist 2019; 24:1-5. [PMID: 30586025 DOI: 10.1097/nrl.0000000000000221] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Cryptococcal meningitis (CM) is found to occur in immunosuppressed patients and those who are immunocompetent. This study aimed to compare the presentation and outcome of CM in patients who are human immunodeficiency virus (HIV) negative with and without immunosuppression. We reviewed 255 clinical records from patients with CM who are HIV negative. The demographic and clinical characteristics, cerebrospinal fluid profiles, brain magnetic resonance imaging, treatment, and outcomes of these individuals were retrospectively analyzed. Among the 255 patients with CM, 91 (35.7%) appeared immunocompetent. CM was present in a younger population in the immunocompetent group (above 50 y, 19.8% vs. 32.3%, P=0.026), with higher initial complaints of visual and auditory symptoms (45.1% vs. 27.4%, P=0.004; 19.8% vs. 9.1%, P=0.016; respectively) and higher cerebrospinal fluid white blood cell counts (30.8% vs. 45.1%, P=0.009) compared with the immunocompromised patients. In addition, the immunocompetent patients had a higher proportion of normal brain images than did the immunocompromised patients (10% vs. 2%, P=0.028). There were no differences in hospital mortality and satisfactory outcomes between the groups (mortality: 10.9% vs. 7.0%, P=0.416; satisfactory outcomes: 76.4% vs. 80.2%, P=0.585). We found significant differences between the immunocompetent and HIV-negative immunocompromised patients; however, there were fewer differences between the groups than expected. Further studies assessing the immune responses in both groups should be performed.
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Cohen R, Babushkin F, Shapiro M, Ben-Ami R, Finn T. Cryptococcosis as a cause of nephrotic syndrome? A case report and review of the literature. IDCases 2018; 12:142-148. [PMID: 29942774 PMCID: PMC6011143 DOI: 10.1016/j.idcr.2018.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 12/27/2022] Open
Abstract
We present a case of a 74 years old male with cutaneous cryptococcosis of the right forearm. Cryptococcus neoformans var. neoformans was cultivated from the skin and from the bloodstream. He was diagnosed with nephrotic syndrome (focal segmental glomerulosclerosis) 21 months prior to admission, which was steroid-dependent. He was treated with prednisone and cyclosporine A. Concurrently with his renal disease he was also diagnosed as having disseminated severe tinea mannum, tinea corporis and tinea cruris; onychomycosis, skin eczema and psoriasis. After a prolonged course of anti-fungal therapy, his skin lesions as well as his nephrotic syndrome recovered completely. Follow up after 7 months without any anti-fungal or immunosuppression showed no skin or renal recurrence. We assume that the renal disease was related to the pre-existing cutaneous cryptococcosis, aggravated by immunosuppression, and discuss the close association between cutaneous cryptococcosis and nephrotic syndrome, as well as similar case reports in the literature.
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Affiliation(s)
- Regev Cohen
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Netanya, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Frida Babushkin
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Netanya, Israel
| | - Maurice Shapiro
- Intensive care unit, Sanz Medical Center, Laniado Hospital, Netanya, Israel
| | - Ronen Ben-Ami
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Infectious Diseases Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Talya Finn
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Netanya, Israel
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Li Y, Fang W, Jiang W, Hagen F, Liu J, Zhang L, Hong N, Zhu Y, Xu X, Lei X, Deng D, Xu J, Liao W, Boekhout T, Chen M, Pan W. Cryptococcosis in patients with diabetes mellitus II in mainland China: 1993-2015. Mycoses 2017; 60:706-713. [PMID: 28857298 DOI: 10.1111/myc.12645] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 05/22/2017] [Accepted: 05/24/2017] [Indexed: 12/13/2022]
Abstract
Diabetes mellitus II (DM II) is a newly defined independent factor contributing to the morbidity and mortality of cryptococcosis. This retrospective case analysis aims to explore the epidemiology, clinical profile and strain characteristics of cryptococcosis in Chinese DM II patients. This study included 30 cases of cryptococcosis with DM II occurring from 1993 to 2015 in mainland China. The hospital-based prevalence of cryptococcosis in DM II was 0.21%. The mean age of the patients was 56.1 years (95% confidence interval: 51.5, 60.6), and 93% of the patients were older than 40 years. Sixty-two per cent of the patients experienced untreated or poorly controlled blood glucose before infection. Multilocus sequence typing analysis categorised all cultured strains as Cryptococcus neoformans and sequence type 5. Sixty-nine per cent of pulmonary cryptococcosis patients experienced misdiagnoses and treatment delays. Sixty per cent of cryptococcal meningitis patients received substandard antifungal therapy. The overall death rate was 33%. Considering the large population size of DM II patients in China, improved attention should be paid to the high prevalence of cryptococcosis as revealed by us. We also emphasised the importance of blood glucose control for infection prevention, especially among the elderly.
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Affiliation(s)
- Yingfang Li
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Wenjie Fang
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Weiwei Jiang
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Ferry Hagen
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands
| | - Jia Liu
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Lei Zhang
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Nan Hong
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Yu Zhu
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Xiaoguang Xu
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Xia Lei
- Department of Dermatology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Danqi Deng
- Department of Dermatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jianping Xu
- Department of Biology, McMaster University, Hamilton, ON, Canada
| | - Wanqing Liao
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Teun Boekhout
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Institute of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, the Netherlands.,Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands
| | - Min Chen
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands
| | - Weihua Pan
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
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Hong N, Chen M, Fang W, Al-Hatmi AMS, Boekhout T, Xu J, Zhang L, Liu J, Pan W, Liao W. Cryptococcosis in HIV-negative Patients with Renal Dialysis: A Retrospective Analysis of Pooled Cases. Mycopathologia 2017; 182:887-896. [PMID: 28667348 PMCID: PMC5587633 DOI: 10.1007/s11046-017-0163-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 06/13/2017] [Indexed: 01/04/2023]
Abstract
Cryptococcosis is a lethal fungal infection mainly caused by Cryptococcus neoformans/C. gattii species. Currently, our understanding of cryptococcosis episodes in HIV-negative patients during renal dialysis remains scarce and fragmented. Here, we performed an analysis of pooled cases to systemically summarize the epidemiology and clinical characteristics of cryptococcosis among HIV-negative patients with renal dialysis. Using pooled data from our hospital and studies identified in four medical databases, 18 cases were identified and analyzed. The median duration time of renal dialysis for peritoneal renal dialysis and hemodialysis cases was 8 months and 36 months, respectively. Several non-neoformans/gattii species were identified among the renal dialysis recipients with cryptococcosis, particularly Cryptococcus laurentii and Cryptococcus albidus, which share similar clinical manifestations as those caused by C. neoformans and C. gattii. Our analyses suggest that physicians should consider the possibility of the occurrence of cryptococcosis among renal dialysis recipients even when cryptococcal antigen test result is negative. The timely removal of the catheter is crucial for peritoneal dialysis patients with cryptococcosis. In addition, there is a need for optimized antifungal treatment strategy in renal dialysis recipients with cryptococcal infections.
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Affiliation(s)
- Nan Hong
- Shanghai Key Laboratory of Molecular Medical Mycology, Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Min Chen
- Shanghai Key Laboratory of Molecular Medical Mycology, Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Wenjie Fang
- Shanghai Key Laboratory of Molecular Medical Mycology, Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Abdullah M S Al-Hatmi
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.,Directorate General of Health Services, Ministry of Health, Ibri Hospital, Ibri, Oman
| | - Teun Boekhout
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.,Institute of Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Amsterdam, The Netherlands
| | - Jianping Xu
- Department of Biology, McMaster University, Hamilton, Canada
| | - Lei Zhang
- Shanghai Key Laboratory of Molecular Medical Mycology, Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Jia Liu
- Shanghai Key Laboratory of Molecular Medical Mycology, Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Weihua Pan
- Shanghai Key Laboratory of Molecular Medical Mycology, Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
| | - Wanqing Liao
- Shanghai Key Laboratory of Molecular Medical Mycology, Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
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