Intra-abdominal Cryptococcosis by Cryptococcus gattii: Case Report and Review

Araujo, Bruno Schneider de; Bay, Mônica Baumgardt; Reichert, Roberta; Goldani, Luciano Zubaran

doi:10.1007/s11046-011-9517-4

Cited by 9 publications

(10 citation statements)

References 23 publications

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“…Other than pulmonary and neurological (including eye) disease, C. gattii infections may involve skin, soft tissues, bone, joint, larynx, bone marrow, and lymph nodes (29,131,206,234,287). Intra-abdominal infection is uncommon but is important, as it may be mistaken for underlying cancer (233). Primary cutaneous C. gattii infection has been reported for only a few patients, including patients from Australia and Brazil.…”

Section: Sites Of Infectionmentioning

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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Section: Sites Of Infectionmentioning

confidence: 99%

Cryptococcus gattii Infections

2014

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“…CAT that included amphotericin B had better results 7,[12][13][14]17,21 in contrast with only one antifungal, either fluconazole 8,10 or amphotericin B. 16,18 In non-HIV patients, clinical manifestations are abdominal pain 15,[23][24][25][26][27] and melena 23,28 ; seven of these reports described a secondary immunosuppressive condition. 15,23,[25][26][27]29,30 Characteristics of gastrointestinal injuries were mass-like lesions, 26,28 lymphadenopathies, 23,25 ulcers, 15,23,27,29,30 and perforations.…”

Section: Discussionmentioning

confidence: 99%

“…15 Two cases were treated just with fluconazole 23,24 and one patient died 24 ; the rest of the patients were treated with CAT showing clinical improvement and resolution of disease. 15,[25][26][27][28][29] Due to its ubiquity, Cryptococcus spp. should be considered as one of the etiologies in patients with immunosuppressive conditions that have chronic gastrointestinal manifestations.…”

Section: Discussionmentioning

confidence: 99%

Colonic cryptococcosis as a rare presentation in HIV infection: a case report and review of the literature

2020

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Colonic cryptococcal infection is unusual in people living with HIV (PLWH) and even more so without concomitant neurological compromise. Published case reports describe diarrhea and other intestinal manifestations that are often confused with systemic tuberculosis infection. We describe an Peruvian woman living with HIV on antiretroviral therapy who presented hypotensive with a 6-month history of fever and epigastric pain, in addition to episodes of sporadic diarrhea. Due to the suspicion of systemic tuberculosis, antituberculosis treatment was started. Days later, without clinical improvement, colonoscopy revealed ulcers in the transverse colon. Histopathological examination of biopsied tissue was compatible with Cryptococcus spp. She received antifungal therapy with amphotericin B and fluconazole. Despite the treatment, the patient died six days later from multiple organ failure.

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“…Cryptococcal lymphadenopathy has been reported in HIV and immunocompetent patients with some and apparently no immune deficiency [ 1 , 15 – 17 ]. Karagüzel reported a child with mesenteric cryptococcal lymphadenitis who presented with acute abdomen [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Abdominal Lymphonodular Cryptococcosis in an Immunocompetent Child

Zaidi

Qureshi

Shakoor

et al. 2015

Case Reports in Pediatrics

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We describe our experience with an apparently immunocompetent child presenting with pyrexia of unknown origin without focal signs. Investigations revealed lymphadenopathy at lung hila, mesentery, and porta hepatis. The child had received at least two months of empiric antituberculous therapy (ATT) before she came to us. A CT-guided biopsy revealed granulomatous inflammation. PAS stain showed yeasts which stained blue with Alcian blue, suggesting C. neoformans.

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Intra-abdominal Cryptococcosis by Cryptococcus gattii: Case Report and Review

Cited by 9 publications

References 23 publications

Cryptococcus gattii Infections

Cryptococcus gattii Infections

Colonic cryptococcosis as a rare presentation in HIV infection: a case report and review of the literature

Abdominal Lymphonodular Cryptococcosis in an Immunocompetent Child

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