Clinical and Host Differences Between Infections with the Two Varieties of Cryptococcus neoformans

Speed, Bryan; Dunt, David

doi:10.1093/clinids/21.1.28

Cited by 423 publications

(362 citation statements)

References 17 publications

Supporting

Mentioning

332

Contrasting

Unclassified

Order By: Relevance

“…Infections caused by both species of the C. neoformans/C. gattii species complex exhibit differences concerning their clinical presentation, among others; it is known that C. gattii invades the parenchyma more often than C. neoformans, and that in patients infected by C. gattii pulmonary infections are more common (5,30). However, in this study, clinical manifestations were similar in the cases attributed to either one of the 2 species, as observed in the period of time previously analyzed (16 Cryptococcal disease continues to be an important cause of death, with a 24.4% found in this study, particularly in HIV patients, showing the delay in diagnosis and calling the attention to the need to consider cryptococcal infection in the differential diagnosis of immunocompromised patients presenting with meningitis, pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Criptococosis en Colombia: resultados de la encuesta nacional, 2006-2010

et al. 2012

View full text Add to dashboard Cite

Introduction: A survey on cryptococcosis is being conducted regularly in Colombia since 1997. We present hereby the results corresponding to patients diagnosed from 2006 to 2010. Objective: To analyze the data obtained during this period. Materials and methods:Retrospective analysis of the corresponding surveys. Results: A total of 526 surveys originating from 72% of the Colombian political divisions were received during the 5-year period. Most patients (76.6%) were males and 74.9% were 21-50 years old. The most prevalent risk factor was HIV infection (83.5%) with cryptococcosis defining AIDS in 23% of the cases. In the general population the estimated mean annual incidence rate for cryptococcosis was 2.4 x 10 6 inhabitants while in AIDS patients this rate rose to 3.3 x 10 3 . In 474 surveys stating clinical features, most frequent complaints were headache 84.5%, fever 63.4%, nausea and vomiting 57.5%, mental alterations 46.3%, meningeal signs 33.0%, cough 26.4% and visual alterations 24.5%. Neurocryptococcosis was recorded in 81.8% of the cases. Laboratory diagnosis was based on direct examination, culture and latex in 29.3% cases. From 413 Cryptococcus isolates analyzed, 95.6% were identified as C. neoformans var. grubii, 1% C. neoformans var. neoformans, and 3.4% C. gattii. Treatment was reported for 71.6% of the cases with amphotericin B alone or in combination with fluconazole prescribed in 28%. Conclusions: Surveys done through passive surveillance continue to be sentinel markers for HIV infection and represent a systematic approach to the study of opportunistic problems regularly afflicting AIDS patients since cryptococcosis requires no compulsory notification in Colombia. Author contributions:Patricia Escandón: played an important role in writing and preparing the manuscript, in charge of the surveillance at the Instituto Nacional de Salud, controlled receipt of questionnaires. Catalina de Bedout: in charge of the mycological diagnosis for all Corporación para Investigaciones Biológicas cases, established links with physicians in charge of patients, controlled receipt of questionnaires and performed the susceptibility testing in all isolates. Jairo Lizarazo: physician in charge of the patients from Norte de Santander, checked the questionnaire's contents for medical accuracy, analyzed the data through statistical analysis. Clara Inés Agudelo: worked all long in the surveillance study, played an important role in preparation of the manuscript and in the analysis of the data, including statistical tests. Ángela Tobón: examined many of the Corporación para Investigaciones Biológicas patients, filled in the corresponding questionnaires, supervised the clinical aspects of most patients and served as a consultant for other physicians in charge of cryptococcosis patients. Solmara Bello: in charge of the mycological diagnosis for Instituto Nacional de Salud cases. Ángela Restrepo: surveillance of the whole program, contacting physicians and serving as consultant for all participants, analyzing data, writing of ...

show abstract

Section: Discussionmentioning

confidence: 99%

Criptococosis en Colombia: resultados de la encuesta nacional, 2006-2010

et al. 2012

View full text Add to dashboard Cite

show abstract

“…grubii, serotype A and C. neoformans var. neoformans, serotype D, have been mostly isolated from immunocompromised host with disseminated cryptococcosis, while C. gattii, serotypes B and C is most often associated with neurological disorders in hosts with normal immunity (2)(3)(4) and with disease in domestic animals (5)(6)(7). Infections are mainly acquired via inhalation of basidiospores from the environment, which are the principal infectious propagules for the C. neoformans/ C. gattii species complex (8).…”

Section: Cryptococcus Gattii Serotype B In Cúcutamentioning

confidence: 99%

Primer aislamiento ambiental de Cryptococcus gattii de serotipo B, en Cúcuta, Colombia

Firacative

Torres

Rodríguez³

et al. 2011

biomedica

View full text Add to dashboard Cite

Introduction. In Cúcuta, Cryptococcus gattii serotype B is commonly recovered from immunocompetent patients with cryptococcosis, but it has not been recovered from the environment in spite of its high incidence which is 77% out of reported cases. Objective. The aim of this work was to carry out an extensive environmental sampling in Cúcuta, in an attempt to isolate C. gattii serotype B and to expand our knowledge about the ecology and epidemiology of this important yeast. Materials and methods. Samples associated with 3,634 trees from 40 zones of Cúcuta were collected and processed with 28 samples collected near the houses of four patients with cryptococcosis caused by C. gattii serotype B. The serotype of the recovered isolates was done using multiplex PCR, molecular patterns were determined by RFLP of the URA5 gene and mating type was determined using the primers MfαU, MfαL, MFa2U and MFa2L. Results. In total, 4,389 samples were processed and one isolate of C. gattii serotype B (VGI/a), two isolates of C. gattii serotype C (VGIII/α) and three isolates of C. neoformans var. grubii, serotype A (VNI/α), were recovered. The density of the recovered isolates varied from 50 to 350 cfu/g of soil.Conclusions. This is the first report on the environmental isolation of C. gattii serotype B from Cúcuta. However, because of the low rate of recovery of isolates from soil only, the environmental niche of C. gattii has not been established and further environmental studies in Cúcuta are necessary, owing that this serotype is not only causing cryptococcosis but also has shown a higher virulence after the Vancouver outbreak.

show abstract

“…The need for recognition of the two species within C. neoformans is warranted not only because of their biologic and ecological differences, but also because they tend to infect different hosts. C. gattii infections have been documented more commonly in immunocompetent individuals, whereas a majority of the patients infected with C. neoformans are immunocompromised, often due to HIV infection [10,11]. Furthermore, some reports have suggested that infections due to C. gattii carry a worse prognosis [12].…”

Section: Classification Of Cryptococcus Neoformans and C Gattiimentioning

confidence: 99%

Phenotypic Switching of Cryptococcus neoformans and Cryptococcus gattii

Jain

Fries

2008

Mycopathologia

View full text Add to dashboard Cite

Microorganisms that live in fluctuating environments must constantly adapt their behavior to survive. The host constitutes an important microenvironment in opportunistic and primary fungal pathogens like Cryptococcus neoformans (C. neoformans) and Cryptococcus gattii (C. gattii). In clonal populations, adaptation may be achieved through the generation of diversity. For fungi phenotype switching constitutes a mechanism that allows them to change rapidly. Both C. neoformans and C. gattii undergo phenotypic switching, which allows them to be successful pathogens and cause persistent disease. Similar to other encapsulated microbes that exhibit phenotypic variation, phenotypic switching in Cryptococcus changes the polysaccharide capsule. Most importantly, in animal models phenotypic switching affects virulence and can change the outcome of infection. Virulence changes because C. neoformans and C. gattii switch variants elicit different inflammatory responses in the host. This altered host response can also affect the response to antifungal therapy and in some cases may even promote the selection of switch variants. This review highlights the similarity and difference between phenotypic switching in C. neoformans and C. gattii, the two dominant species that cause cryptococcosis in humans.

show abstract

Clinical and Host Differences Between Infections with the Two Varieties of Cryptococcus neoformans

Cited by 423 publications

References 17 publications

Criptococosis en Colombia: resultados de la encuesta nacional, 2006-2010

Criptococosis en Colombia: resultados de la encuesta nacional, 2006-2010

Primer aislamiento ambiental de Cryptococcus gattii de serotipo B, en Cúcuta, Colombia

Phenotypic Switching of Cryptococcus neoformans and Cryptococcus gattii

Contact Info

Product

Resources

About