A Case of Recurrent Cryptococcal Meningoencephalitis in an Immunocompetent Female

Niknam, Negin; Dushaj, Kola; Restrepo, Erfidia

doi:10.1155/2014/407348

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…Of the 46 studies included, 20 were cohorts 4 , 10 , 14 – 18 , 21 – 33 and 26 were case reports/series. 12 , 34 – 58 The cohort studies were divided in 7 two-arm (groups with and without shunt) and 13 one-arm (group with shunt) studies, and their characteristics are summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Cerebrospinal fluid shunting for the management of cryptococcal meningitis: a scoping review

Cornejo-Venegas,

Carreras,

Salcedo

et al. 2024

Therapeutic Advances in Infection

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Objective: This scoping review aimed to describe studies that evaluate the management of cryptococcal meningitis (CM) using cerebrospinal fluid (CSF) shunts, types of shunts used, and clinically relevant patient outcomes. Methods: We searched in the following databases: PubMed, Web of Science/Core collection, Embase, the Cochrane Library, and clinicaltrials.gov on 1 April 2022. We included two-arm and one-arm cohort studies that evaluated clinically relevant patient outcomes. Case reports were used to describe the type of CSF shunts used and the rationale behind its selection. The selection and extraction processes were independently performed by two authors. Results: This study included 20 cohort studies and 26 case reports. Only seven cohort studies compared two groups. Ventriculoperitoneal shunt was the most commonly used type of shunt (82.1%). The main indications for placing a shunt were persistently high opening pressure (57.1%) and persisting neurological symptoms or deterioration (54.3%). Cohort studies suggest that patients with shunt showed improvement in some outcomes such as neurological symptoms and hospital stay length. The most common shunt complications were post-operative fever (1–35.6%) and shunt obstruction (7–16%). Conclusion: CSF shunts may improve some clinically relevant outcomes in patients with CM, but the evidence is very uncertain.

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Section: Resultsmentioning

confidence: 99%

Cerebrospinal fluid shunting for the management of cryptococcal meningitis: a scoping review

Cornejo-Venegas,

Carreras,

Salcedo

et al. 2024

Therapeutic Advances in Infection

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“…A neurocriptococose consiste em uma infecção do Sistema Nervoso Central (SNC) suscitada pelo fungo encapsulado Cryptococcus sp. (Niknam et al, 2014;Jha et al, 2019). As infecções provocadas por essa espécie são oportunistas, urbanas e frequentemente estão associadas a condições de imunossupressão e à Síndrome da Imunodeficiência Adquirida (AIDS) (Andrade et al, 2018;Murphy et al, 2020).…”

Section: Introductionunclassified

“…As infecções provocadas por essa espécie são oportunistas, urbanas e frequentemente estão associadas a condições de imunossupressão e à Síndrome da Imunodeficiência Adquirida (AIDS) (Andrade et al, 2018;Murphy et al, 2020). Já em pacientes imunocompetentes é considerada rara e pode provocar dúvidas na determinação das causas de doenças meningoencefálicas (Niknam et al, 2014;Jha et al, 2019).…”

Section: Introductionunclassified

“…Em suma, sabe-se que apesar da alta incidência de infecções pelo Cryptococcus neoformans em pacientes imunodeprimidos, podem ocorrer casos em imunocompetentes (Niknam et al, 2014;Murphy et al, 2020). Além disso, cepas estão ficando resistentes, o que pode estar relacionado ao aumento da incidência e do uso de antifúngicos (Pappalardo;Melhem, 2003).…”

Section: Introductionunclassified

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Neurocriptococose por Cryptococcus neoformans em paciente imunocompetente

Martinussi,

Marçal

et al. 2024

CLCS

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A neurocriptococose consiste em uma infecção que atinge o Sistema Nervoso Central, e é provocada pelo fungo Cryptococcus sp. Normalmente atinge indivíduos imunossuprimidos, mas ainda que raramente, pode atingir indivíduos imunocompetentes. Este estudo objetiva relatar o caso de um paciente jovem imunocompetente, com quadro de cefaleia, cegueira e desenvolvimento de hipertensão intracraniana por doença criptocócica. Trata-se de um estudo descritivo retrospectivo, realizado no Hospital Universitário da Faculdade de Medicina da Universidade Federal do Mato Grosso do Sul (HU - UFGD). A pesquisa foi realizada com um paciente do sexo masculino, o qual foi internado no HU – UFGD com neurocriptococose no período de julho a outubro de 2022. Os dados coletados e utilizados na pesquisa foram autorizados mediante assinatura do Termo de Consentimento Livre e Esclarecido (TCLE) e demais documentações em conformidade com o Comitê de Ética e Pesquisa (CEP) de parecer número 6.166.391. Assim, compreende-se que este estudo auxilia a pensarmos na possibilidade de neurocriptococose em pacientes sem imunodeficiência quando estivermos diante de um quadro compatível com meningite, hipertensão intracraniana e até mesmo crises convulsivas, podendo assim prestarmos assistência rápida e corretamente na tentativa de prevenirmos possíveis sequelas. Por fim, vale ressaltar a necessidade de produções científicas que abordem a temática.

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“…Male predominance was apparent in most of the previous CM studies in different countries [ 1 , 7 – 10 ], but recently the noticeable increase in female prevalence was seen, as suggested by the decreased male-to-female ratio [ 10 , 11 ]. Until now, several reports have called attention to the female CM patients [ 12 – 16 ], but no statistical study of these patients was found.…”

Section: Introductionmentioning

confidence: 99%

Gender-specific contributing risk factors and outcome of female cryptococcal meningoencephalitis patients

Zheng

Wang

et al. 2015

BMC Infect Dis

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BackgroundAlthough male predominance was documented in previous studies on cryptococcal meningoencephalitis (CM), there has been no statistical study about female CM patients despite recently noticeable increase in female prevalence. In the current study, we aimed to investigate the independent gender-specific contributing risk factors for onset of CM and factors related to survival time in female patients by chosen statistical tools.MethodsThere have been 108 patients diagnosed with CM from July 1, 1998 to June 30, 2013 in Nanfang Hospital that were included in our study. This 15-year retrospective study compared demographic and clinical features of 31 female patients with 77 males. Multivariate analysis was performed for detection of the contributors to the onset of CM in female patients. The independent variables for multivariate analysis were selected according to statistical significance in univariate analysis. Furthermore, Cox regression model was used to evaluate the factors related to survival length.ResultsUse of corticosteroids or other immunosuppressants (32.3 % versus 11.7 %; p = 0.011) and history of systemic lupus erythematosus (SLE) and other autoimmune diseases (29 % versus 3.9 %; p < 0.001) were more common in females, but only the history of SLE or other autoimmune diseases was significant (OR 10.59, 95 % CI 1.49-74.77, p = 0.02) by multivariate analysis. The ratio of cerebrospinal fluid (CSF) glucose-to-blood glucose was related to the survival time (p = 0.03, 95 % CI 0-0.71).ConclusionsThe results showed that the history of SLE or other autoimmune diseases rather than chronic use of corticosteroids and/or immunosuppressants was the independent gender-specific contributing risk factor in female CM patients. Therefore, more attention should be made to the prevention of infection from the genus Cryptococcus spp. in female patients with SLE or other autoimmune diseases. In addition, decreased ratio of CSF glucose-to-blood glucose before antifungal therapy predicted the worse prognosis.

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A Case of Recurrent Cryptococcal Meningoencephalitis in an Immunocompetent Female

Cited by 5 publications

References 7 publications

Cerebrospinal fluid shunting for the management of cryptococcal meningitis: a scoping review

Cerebrospinal fluid shunting for the management of cryptococcal meningitis: a scoping review

Neurocriptococose por Cryptococcus neoformans em paciente imunocompetente

Gender-specific contributing risk factors and outcome of female cryptococcal meningoencephalitis patients

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