Disseminated Cryptococcus neoformans after treatment with infliximab for rheumatoid arthritis

Kozic, Heidi; Riggs, Karen; Ringpfeil, Franziska; Lee, Jason B.

doi:10.1016/j.jaad.2006.12.015

Cited by 20 publications

(11 citation statements)

References 5 publications

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“…Cryptococcus neoformans is a fungal pathogen of humans that causes life-threatening cryptococcal meningitis in immunocompromised patients, in particular those with advanced AIDS 1 . Cryptococcal meningitis is also found associated with a large variety of other immune deficient states, including in patients on immunosuppressive therapies 2 3 , those with hematological malignancy and other more oblique disorders 4 . However, there are a number of unifying features in susceptibility to cryptococcal disease, notably a failure in a pro-inflammatory immune response to primary infection 4 5 6 .…”

mentioning

confidence: 99%

Cryptococcus neoformans Intracellular Proliferation and Capsule Size Determines Early Macrophage Control of Infection

Bojarczuk

Miller

Hotham

et al. 2016

Sci Rep

157

185

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Cryptococcus neoformans is a significant fungal pathogen of immunocompromised patients. Many questions remain regarding the function of macrophages in normal clearance of cryptococcal infection and the defects present in uncontrolled cryptococcosis. Two current limitations are: 1) The difficulties in interpreting studies using isolated macrophages in the context of the progression of infection, and 2) The use of high resolution imaging in understanding immune cell behavior during animal infection. Here we describe a high-content imaging method in a zebrafish model of cryptococcosis that permits the detailed analysis of macrophage interactions with C. neoformans during infection. Using this approach we demonstrate that, while macrophages are critical for control of C. neoformans, a failure of macrophage response is not the limiting defect in fatal infections. We find phagocytosis is restrained very early in infection and that increases in cryptococcal number are driven by intracellular proliferation. We show that macrophages preferentially phagocytose cryptococci with smaller polysaccharide capsules and that capsule size is greatly increased over twenty-four hours of infection, a change that is sufficient to severely limit further phagocytosis. Thus, high-content imaging of cryptococcal infection in vivo demonstrates how very early interactions between macrophages and cryptococci are critical in the outcome of cryptococcosis.

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mentioning

confidence: 99%

Cryptococcus neoformans Intracellular Proliferation and Capsule Size Determines Early Macrophage Control of Infection

Bojarczuk

Miller

Hotham

et al. 2016

Sci Rep

157

185

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“…Cryptococcosis: pneumonia and pulmonary infection [ 258 , 259 ], disseminated infection [ 260 , 261 ], meningitis [ 262 , 263 ], cutaneous infection [ 264 ]…”

Section: Immunosuppressive Therapy As a Risk Factor For Opportunistic Infectionmentioning

confidence: 99%

“…Toxoplasmosis: toxoplasmic retinochoroiditis [161,162], cerebral toxoplasmosis [163] Cryptococcosis: pneumonia and pulmonary infection [258,259], disseminated infection [260,261], meningitis [262,263], cutaneous infection [264] Pneumocystis jiroveci (carinii) pneumonia [265][266][267][268] Aspergillosis: allergic bronchopulmonary [269], pulmonary [270], sinus aspergillosis [271], central nervous system aspergillosis [272], disseminated [273] Candidiasis: systemic candidiasis [274], arthritis [275], oral candidiasis [276] Mucormycosis: cutaneous [277], gastric perforation [233], disseminated [278], sinusitis [279], pulmonary [280] Strongyloidiasis: hyperinfection [281] Tuberculosis (pulmonary) [282][283][284] CMV retinitis [285], disseminated CMV [286] IL-17A blockers (Ixekizumab) Toxoplasmosis: lymphadenopathy [164] reported species [43,[45][46][47][48]. Other reported Candida species were C. albicans, C. tropicalis, C. parapsilosis, C. orthopsilosis, and C. glabrata among COVID-19 patients [43,49].…”

Section: Il-1 Blockers Aspergillosis [257] Tnf-α Blockersmentioning

confidence: 99%

COVID-19-associated opportunistic infections: a snapshot on the current reports

2021

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Treatment of the novel Coronavirus Disease 2019 (COVID-19) remains a complicated challenge, especially among patients with severe disease. In recent studies, immunosuppressive therapy has shown promising results for control of the cytokine storm syndrome (CSS) in severe cases of COVID-19. However, it is well documented that immunosuppressive agents ( e.g., corticosteroids and cytokine blockers) increase the risk of opportunistic infections. On the other hand, several opportunistic infections were reported in COVID-19 patients, including Aspergillus spp . , Candida spp . , Cryptococcus neoformans , Pneumocystis jiroveci ( carinii ), mucormycosis, Cytomegalovirus (CMV), Herpes simplex virus (HSV), Strongyloides stercoralis, Mycobacterium tuberculosis, and Toxoplasma gondii . This review is a snapshot about the main opportunistic infections that reported among COVID-19 patients. As such, we summarized information about the main immunosuppressive agents that were used in recent clinical trials for COVID-19 patients and the risk of opportunistic infections following these treatments. We also discussed about the main challenges regarding diagnosis and treatment of COVID-19-associated opportunistic infections (CAOIs). Supplementary Information The online version contains supplementary material available at 10.1007/s10238-021-00751-7.

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“…Although pulmonary cryptococcosis may be one of the most important infectious complications of patients with RA, there are few case reports and studies of pulmonary cryptococcosis in these patients. [5][6][7][8][9][10][11][12][13] The clinical and radiological characteristics of pulmonary cryptococcosis in patients with RA have not been fully elucidated. Moreover, whether immunosuppressant drugs can be continued and which antirheumatic drugs can be used safely and efficiently when cryptococcosis develops remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of pulmonary cryptococcosis in patients with rheumatoid arthritis

et al. 2021

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Background and objectiveA high frequency of infections complicating rheumatoid arthritis (RA) has been reported due to the immunomodulatory effect of RA or to agents with immunosuppressive effects used in its treatment. We aimed to assess clinical and radiological characteristics of pulmonary cryptococcosis in patients with and without RA.MethodsWe retrospectively reviewed the medical records of 52 patients with pulmonary cryptococcosis and divided them into two groups, those with RA and without RA, and compared clinical characteristics and radiological findings between them.ResultsEleven (21.2%) of the 52 patients had RA. Median follow-up periods were 51.2 (range: 1.1–258.7) months for patients with RA and 19.1 (range: 0.63–246.9) months for patients without RA. Among the patients with RA, 81.8% were women, with a mean age of 68.1 years. Female sex and respiratory comorbidities were significantly more frequent in patients with RA than in patients without RA. Frequencies of concomitant cryptococcal meningitis and respiratory failure were not different between the groups. There were no significant differences in frequency of any radiological findings, locations and number between the two groups. Among patients with RA, all but one responded well to antifungal treatment. During the antifungal treatment course, one (9.1%) patient with RA died of cryptococcosis. Despite continuing antirheumatic drugs, no patients had recurrence of pulmonary cryptococcosis during follow-up.ConclusionOther than some differences in background, there were no clinical, radiological or prognostic differences between the patients with and without RA with pulmonary cryptococcosis. The administration of antirheumatic therapy had no negative effect on the clinical course of antifungal treatment.

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Disseminated Cryptococcus neoformans after treatment with infliximab for rheumatoid arthritis

Cited by 20 publications

References 5 publications

Cryptococcus neoformans Intracellular Proliferation and Capsule Size Determines Early Macrophage Control of Infection

Cryptococcus neoformans Intracellular Proliferation and Capsule Size Determines Early Macrophage Control of Infection

COVID-19-associated opportunistic infections: a snapshot on the current reports

Characteristics of pulmonary cryptococcosis in patients with rheumatoid arthritis

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