Cryptococcus gattii in the United States: Clinical Aspects of Infection With an Emerging Pathogen

Harris, Julie; Lockhart, Shawn R.; DeBess, Emilio; Marsden-Haug, Nicola; Goldoft, Marcia; Wohrle, Ron; Lee, S.; Smelser, Chad; Park, B.; Chiller, Tom

doi:10.1093/cid/cir723

Cited by 196 publications

(194 citation statements)

References 32 publications

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“…Unlike C. neoformans, which has a global distribution and is a common opportunistic pathogen in HIV-infected or other immunocompromised individuals, C. gattii typically affects patients without HIV infection and is thought to have a more limited environmental distribution. C. gattii infection is considered more difficult to treat than C. neoformans infection and requires longer and more aggressive treatment (19). Before 1999, C. gattii infection was rare in North America.…”

Section: Resultsmentioning

confidence: 99%

Name Changes for Fungi of Medical Importance, 2012 to 2015

Warnock

2017

J Clin Microbiol

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Section: Resultsmentioning

confidence: 99%

Name Changes for Fungi of Medical Importance, 2012 to 2015

Warnock

2017

J Clin Microbiol

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“…In human cryptococcosis due to C. gattii, genotype-associated clinical and host differences have been observed. For example, VGI infection typically presents with CNS disease, including cryptococcomas, often with concurrent lung lesions (130), whereas VGII infection more commonly presents with pulmonary disease (131,132). Both of these molecular types of C. gattii have a predilection for immunocompetent hosts.…”

Section: Pathogenesismentioning

confidence: 99%

Cryptococcus gattii Infections

2014

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SUMMARY Understanding of the taxonomy and phylogeny of Cryptococcus gattii has been advanced by modern molecular techniques. C. gattii probably diverged from Cryptococcus neoformans between 16 million and 160 million years ago, depending on the dating methods applied, and maintains diversity by recombining in nature. South America is the likely source of the virulent C. gattii VGII molecular types that have emerged in North America. C. gattii shares major virulence determinants with C. neoformans , although genomic and transcriptomic studies revealed that despite similar genomes, the VGIIa and VGIIb subtypes employ very different transcriptional circuits and manifest differences in virulence phenotypes. Preliminary evidence suggests that C. gattii VGII causes severe lung disease and death without dissemination, whereas C. neoformans disseminates readily to the central nervous system (CNS) and causes death from meningoencephalitis. Overall, currently available data indicate that the C. gattii VGI, VGII, and VGIII molecular types more commonly affect nonimmunocompromised hosts, in contrast to VGIV. New, rapid, cheap diagnostic tests and imaging modalities are assisting early diagnosis and enabling better outcomes of cerebral cryptococcosis. Complications of CNS infection include increased intracranial pressure, severe neurological sequelae, and development of immune reconstitution syndrome, although the mortality rate is low. C. gattii VGII isolates may exhibit higher fluconazole MICs than other genotypes. Optimal therapeutic regimens are yet to be determined; in most cases, initial therapy with amphotericin B and 5-flucytosine is recommended.

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“…Cryptococcosis is a life-threatening infection caused by Cryptococcus neoformans and C. gattii (4)(5)(6). Current diagnostic procedures of cryptococcosis, whether direct or indirect, have limitations.…”

Section: Discussionmentioning

confidence: 99%

Rapid detection of cryptococcal antigen by a flow assay

et al. 2017

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SummaryCryptococcosis is a life-threatening infection caused by Cryptococcus neoformans and C. gattii. Tests for quick detection of the cryptococcal antigen are needed. This study compares the performance of a lateral flow assay (LFA) to the latex agglutination method. Thirty-five cryopreserved positive samples (sera and cerebrospinal fluids) plus three negative sera for control have been examined. LFA does not need high-temperature incubation or enzyme pre-treatment. All the results, except for one serum, agree with previous obtained with latex agglutination method. LFA has an important clinical utility for its rapidity and sensitivity, and it also can be used as a point-of-care test.

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Cryptococcus gattii in the United States: Clinical Aspects of Infection With an Emerging Pathogen

Abstract: Clinical differences may exist between outbreak-strain (VGIIa, VGIIb, and VGIIc) and nonoutbreak-strain Cg infections in the United States. Clinicians should have a low threshold for testing for Cg, particularly among patients with recent travel to the PNW.

Cited by 196 publications

References 32 publications

Name Changes for Fungi of Medical Importance, 2012 to 2015

Name Changes for Fungi of Medical Importance, 2012 to 2015

Cryptococcus gattii Infections

Rapid detection of cryptococcal antigen by a flow assay

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