Update on Pulmonary Cryptococcosis

Yamamura, Deborah; Xu, Jianping

doi:10.1007/s11046-021-00575-9

Cited by 22 publications

(21 citation statements)

References 81 publications

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“…Annual population with PC was much greater than that of EPC in our hospital although 60% of PC cases were asymptomatic. This percentage is slightly higher than a previous report [12]. A large-scale investigation [3] based on Chinese data reported that the most common symptoms of CM were headache (87%) and fever (74%) which agrees with our ndings.…”

Section: Discussionsupporting

confidence: 90%

Retrospective analysis of pulmonary cryptococcosis and extrapulmonary cryptococcosis in a Chinese tertiary hospital

Shi

Chen

et al. 2023

Preprint

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Cryptococcosis is an invasive fungal disease with increased morbidity in China. Cryptococci can infect immunocompromised hosts as well as immunocompetent ones. In this study, we reviewed data of inpatients with cryptococcosis at Ningbo First Hospital from May 2010 to May 2020 and compared the clinical profiles of pulmonary cryptococcosis (PC) and extrapulmonary cryptococcosis (EPC). Of 71 patients enrolled, 70 were non-HIV with dramatically increased prevalence especially in PC. 77.46% of cases were PC confirmed by pathology. The rest were EPC including intracranial infection (15.49%) and cryptococcemia (7.04%). Comparing to PC, a larger proportion of EPC patients were found to have immunocompromised conditions including predisposing factors (p<0.01), or detectable humoral or cellular immunodeficiency. Fever and headache were more common in EPC patients (p<0.001). Patients with EPC had lower serum sodium level (p=0.041), lower monocyte counts (p=0.025) and higher C-reactive protein (p=0.012). Cryptococcal antigen tests for serum and cerebrospinal fluid showed 100% sensitivity in diagnosing EPC while serum lateral flow assay (LFA) tested negative in 25% of PC. All in all, underlying immunocompromised conditions may predict dissemination in PC without HIV which can be identified by LFA.

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Section: Discussionsupporting

confidence: 90%

Retrospective analysis of pulmonary cryptococcosis and extrapulmonary cryptococcosis in a Chinese tertiary hospital

Shi

Chen

et al. 2023

Preprint

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“…These studies have revealed the diversity and heterogeneity among C. gattii isolates and established that C. gattii is a species complex containing multiple distinct lineages. These lineages are frequently referred to as molecular types and increasingly more as species [ 42 ]. Formally, the C. gattii species complex is divided into six distinct lineages (VGI, VGII, VGIII, VGIV, VGV, and VGVI) [ 3 , 43 , 44 ].…”

Section: Introductionmentioning

confidence: 99%

Global Analyses of Multi-Locus Sequence Typing Data Reveal Geographic Differentiation, Hybridization, and Recombination in the Cryptococcus gattii Species Complex

Hitchcock

2023

JoF

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Cryptococcus gattii species complex (CGSC) is a basidiomycete haploid yeast and globally distributed mammalian pathogen. CGSC is comprised of six distinct lineages (VGI, VGII, VGIII, VGIV, VGV, and VGVI); however, the geographical distribution and population structure of these lineages is incompletely described. In this study, we analyze published multi-locus sequence data at seven loci for 566 previously recorded sequence types (STs) encompassing four distinct lineages (VGI, VGII, VGIII, and VGIV) within the CGSC. We investigate indicators of both clonal dispersal and recombination. Population genetic analyses of the 375 STs representing 1202 isolates with geographic information and 188 STs representing 788 isolates with ecological source data suggested historically differentiated geographic populations with infrequent long-distance gene flow. Phylogenetic analyses of sequences at the individual locus and of the concatenated sequences at all seven loci among all 566 STs revealed distinct clusters largely congruent with four major distinct lineages. However, 23 of the 566 STs (4%) each contained alleles at the seven loci belonging to two or more lineages, consistent with their hybrid origins among lineages. Within each of the four major lineages, phylogenetic incompatibility analyses revealed evidence for recombination. However, linkage disequilibrium analyses rejected the hypothesis of random recombination across all samples. Together, our results suggest evidence for historical geographical differentiation, sexual recombination, hybridization, and both long-distance and localized clonal expansion in the global CGSC population.

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“…Pulmonary cryptococosis is an opportunistic fungal disease caused by cryptococcus, most commonly seen in immunocompromised individuals. Cryptococcus is ubiquitous in the natural enviroment, particularly prevalent in pigeon faeces ( 22 ). In this case, the patient had no history of feeding or close contact with pigeons, so breathing dust contaminated with pigeon faeces may have been the probable route of infection.…”

Section: Discussionmentioning

confidence: 99%

Case report: Recurrent lung infections following treatment with pralsetinib for an elderly patient with RET-fusion positive NSCLC

Chen

Wang

et al. 2022

Front. Oncol.

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Patients with RET fusions represent 1-2% of all cases of non-small cell lung cancer (NSCLC), the majority of whom are younger, and are extremely rare in the elderly. As a selective RET inhibitor, pralsetinib has been shown to be efficacious and well-tolerated in patients with RET-fusion NSCLC. Nevertheless, there are currently insufficient data available for assessing the activity and safety of pralsetinib in elderly patients with NSCLC. Herein, we report an 81-year-old NSCLC patient with KIF5B-RET fusion, who achieved stable disease for more than 9 months at a low-dose of pralsetinib as second-line therapy. Of particular note, during pralsetinb therapy, his clinical course was complicated by cryptococcal pneumonia and staphylococcus aureus lung abscess. Our study demonstrates that pralsetinib is an effective therapeutic option that provides survival benefits for elderly NSCLC patients harboring RET fusion. However, during pralsetinb therapy, treating physicians should maintain particular vigilance for the increased risk of infection, especially in elderly patients.

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Update on Pulmonary Cryptococcosis

Cited by 22 publications

References 81 publications

Retrospective analysis of pulmonary cryptococcosis and extrapulmonary cryptococcosis in a Chinese tertiary hospital

Retrospective analysis of pulmonary cryptococcosis and extrapulmonary cryptococcosis in a Chinese tertiary hospital

Global Analyses of Multi-Locus Sequence Typing Data Reveal Geographic Differentiation, Hybridization, and Recombination in the Cryptococcus gattii Species Complex

Case report: Recurrent lung infections following treatment with pralsetinib for an elderly patient with RET-fusion positive NSCLC

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