Disseminated cryptococcal infection with eosinophilia in a healthy person

Yamaguchi, Hiromichi; Komase, Yuko; Ikehara, Mizuki; Yamamoto, Takahito; Shinagawa, Toshihito

doi:10.1007/s10156-008-0618-z

Cited by 32 publications

(16 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Yamaguchi reported a 23-year-old patient was diagnosed as disseminated cryptococcosis including meningitis with very marked eosinophilia (75 %). And the eosinophilia was successfully alleviated by treatment for cryptococcal meningitis [24]. In addition, infections presenting with elevated IgE have been associated with a high risk of systemic cryptococcal dissemination, including meningitis [25, 26].…”

Section: Discussionmentioning

confidence: 99%

Characteristics and outcomes of cryptococcal meningitis in HIV seronegative children in Beijing, China, 2002–2013

Guo

Liu

et al. 2016

BMC Infect Dis

View full text Add to dashboard Cite

BackgroundData regarding HIV-seronegative pediatric patients with cryptococcal meningitis (CM) have been very limited.MethodsWe retrospectively reviewed non-HIV-infected in patients with CM from January 2002 through December 2013 in Beijing Children’s Hospital. Records of the all patients were obtained and compared.ResultsThe 34 children had a median age of 5.6 years. Most of the patients were male (67.6 %). Only 23.5 % of the cases had identifiable underlying diseases. The sensitivity of the CSF cryptococcal antigen, India ink smear and CSF culture in our study were 81.5, 85.3 and 82.4 %, respectively. And the sensitivity of combinations of these tests was 91.2 %. Out of the 34 patients, 16 (47.1 %) had other organs involvement in addition to the brain. The main abnormal features via magnetic resonance imaging (MRI) were Virchow-Robin space dilatation (44.4 %), hydrocephalus (38.9 %), gelatinous pseudocysts (33.3 %), brain atrophy (33.3 %), meningeal enhancement (27.8 %) and local lesions (27.8 %). In total, 64.7 % of the patients were successfully treated at discharge, whereas treatment failed in 35.3 % of the patients.ConclusionsCryptococcal meningitis is an infrequent disease with a high fatality rate in children in China. The majority of patients were apparently healthy. Clinicians should consider cryptococcal infection as a potential pathogen of pediatric meningitis. Cryptococcal antigen, India ink smear and culture tests are recommended for diagnosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Characteristics and outcomes of cryptococcal meningitis in HIV seronegative children in Beijing, China, 2002–2013

Guo

Liu

et al. 2016

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…C57BL/6 mice develop eosinophilic pneumonia in response to pulmonary cryptococcal infection [92] and eosinophilia has also been observed in human cryptococcosis [93]. …”

Section: Innate Immune and Cellular Responses To C Neoformansmentioning

confidence: 99%

Host Immunity to Cryptococcus Neoformans

2015

View full text Add to dashboard Cite

Cryptococcosis is caused by the fungal genus Cryptococcus. Cryptococcosis, predominantly meningoencephalitis, emerged with the HIV pandemic, primarily afflicting HIV-infected patients with profound T-cell deficiency. Where in use, combination antiretroviral therapy has markedly reduced the incidence of and risk for disease, but cryptococcosis continues to afflict those without access to therapy, particularly in sub-Saharan Africa and Asia. However, cryptococcosis also occurs in solid organ transplant recipients and patients with other immunodeficiencies as well as those with no known immunodeficiency. This article reviews innate and adaptive immune responses to C. neoformans, with an emphasis on recent studies on the role of B cells, natural IgM and Fc gamma receptor polymorphisms in resistance to cryptococcosis.

show abstract

“…Mycosis can cause a variety of infectious diseases, including invasive and non-invasive mycosis, as well as allergic diseases, such as pulmonary eosinophilia, bronchial asthma and hypersensitivity pneumonitis. According to our PubMed search, only a few case reports have reported the complication of pulmonary eosinophilia in the course of invasive mycosis [7–10]. The pathogens in these five cases were Aspergillus or Cryptococcus .…”

Section: Discussionmentioning

confidence: 99%

Invasive pulmonary mucormycosis: rare presentation with pulmonary eosinophilia

et al. 2017

View full text Add to dashboard Cite

BackgroundFungi can cause a variety of infectious diseases, including invasive mycosis and non-invasive mycosis, as well as allergic diseases. The different forms of mycosis usually have been described as mutually exclusive, independent entities, with few descriptions of overlapping cases. Here, we describe the first reported case of a patient with the complication of pulmonary eosinophilia in the course of invasive mucormycosis.Case presentationA 74-year-old Japanese man with asthma-COPD overlap underwent emergency surgery for a ruptured abdominal aortic aneurysm. The surgery was successful, but fever and worsening dyspnea appeared and continued from postoperative day (POD) 10. A complete blood count showed leukocytosis with neutrophilia and eosinophilia, and the chest X-ray showed consolidation of the left upper lung at POD 15. We suspected nosocomial pneumonia together with an exacerbation of the asthma-COPD overlap, and both antibiotics and bronchodilator therapy were initiated. However, the symptoms, eosinophilia and imaging findings deteriorated. We then performed a bronchoscopy, and bronchoalveolar lavage (BAL) fluid analysis revealed an increased percentage of eosinophils (82% of whole cells) as well as filamentous fungi. We first suspected that this was a case of allergic bronchopulmonary mycosis (ABPM) caused by Aspergillus infection and began corticosteroid therapy with an intravenous administration of voriconazole at POD 27. However, the fungal culture examination of the BAL fluid revealed mucormycetes, which were later identified as Cunninghamella bertholletiae by PCR and DNA sequencing. We then switched the antifungal agent to liposomal amphotericin B for the treatment of the pulmonary mucormycosis at POD 29. Despite replacing voriconazole with liposomal amphotericin B, the patient developed septic shock and died at POD 39. The autopsy revealed that filamentous fungi had invaded the lung, heart, thyroid glands, kidneys, and spleen, suggesting that disseminated mucormycosis had occurred.ConclusionsWe describe the first reported case of pulmonary mucormycosis with pulmonary eosinophilia caused by Cunninghamella bertholletiae, which resulted in disseminated mucormycosis. Although it is a rather rare case, two important conclusions can be drawn: i) mycosis can simultaneously cause both invasive infection and a host allergic reaction, and ii) Cunninghamella bertholletiae rarely infects immunocompetent patients.

show abstract

Disseminated cryptococcal infection with eosinophilia in a healthy person

Cited by 32 publications

References 13 publications

Characteristics and outcomes of cryptococcal meningitis in HIV seronegative children in Beijing, China, 2002–2013

Characteristics and outcomes of cryptococcal meningitis in HIV seronegative children in Beijing, China, 2002–2013

Host Immunity to Cryptococcus Neoformans

Invasive pulmonary mucormycosis: rare presentation with pulmonary eosinophilia

Contact Info

Product

Resources

About