cryptococcal meningitis

Summary

Summary: Meningeal inflammation produced by CRYPTOCOCCUS NEOFORMANS, an encapsulated yeast that tends to infect individuals with ACQUIRED IMMUNODEFICIENCY SYNDROME and other immunocompromised states. The organism enters the body through the respiratory tract, but symptomatic infections are usually limited to the lungs and nervous system. The organism may also produce parenchymal brain lesions (torulomas). Clinically, the course is subacute and may feature HEADACHE; NAUSEA; PHOTOPHOBIA; focal neurologic deficits; SEIZURES; cranial neuropathies; and HYDROCEPHALUS. (From Adams et al., Principles of Neurology, 6th ed, pp721-2)

Top Publications

  1. Brouwer A, Rajanuwong A, Chierakul W, Griffin G, Larsen R, White N, et al. Combination antifungal therapies for HIV-associated cryptococcal meningitis: a randomised trial. Lancet. 2004;363:1764-7 pubmed
    It frequently takes more than 2 weeks for drug treatments for cryptococcal meningitis to sterilise cerebrospinal fluid (CSF)...
  2. Huston K, Gelber A. Simultaneous presentation of cryptococcal meningitis and lupus nephritis. J Rheumatol. 2005;32:2501-2 pubmed
  3. Kambugu A, Meya D, Rhein J, O Brien M, Janoff E, Ronald A, et al. Outcomes of cryptococcal meningitis in Uganda before and after the availability of highly active antiretroviral therapy. Clin Infect Dis. 2008;46:1694-701 pubmed publisher
    b>Cryptococcal meningitis (CM) is the proximate cause of death in 20%-30% of persons with acquired immunodeficiency syndrome in Africa...
  4. Panomvana Na Ayudhya D, Thanompuangseree N, Tansuphaswadikul S. Effect of rifampicin on the pharmacokinetics of fluconazole in patients with AIDS. Clin Pharmacokinet. 2004;43:725-32 pubmed
    ..of fluconazole and on clinical outcomes of fluconazole treatment in patients with AIDS-related cryptococcal meningitis. Forty Thai patients with AIDS and cryptococcal meningitis, of whom 20 had been receiving oral rifampicin ..
  5. Lawn S, Bekker L, Myer L, Orrell C, Wood R. Cryptococcocal immune reconstitution disease: a major cause of early mortality in a South African antiretroviral programme. AIDS. 2005;19:2050-2 pubmed
  6. Park B, Wannemuehler K, Marston B, Govender N, Pappas P, Chiller T. Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS. AIDS. 2009;23:525-30 pubmed publisher
    b>Cryptococcal meningitis is one of the most important HIV-related opportunistic infections, especially in the developing world...
  7. Bicanic T, Harrison T. Cryptococcal meningitis. Br Med Bull. 2004;72:99-118 pubmed
    b>Cryptococcal meningitis is a common opportunistic infection in AIDS patients, particularly in Southeast Asia and Africa. Cases also occur in patients with other forms of immunosupression and in apparently immunocompetent individuals...
  8. Lu H, Zhou Y, Yin Y, Pan X, Weng X. Cryptococcal antigen test revisited: significance for cryptococcal meningitis therapy monitoring in a tertiary chinese hospital. J Clin Microbiol. 2005;43:2989-90 pubmed
    For a total of 29 non-human immunodeficiency virus 1 cryptococcal meningitis cases, titer changes in the latex agglutination test before and after therapy were reviewed along with clinical manifestations, laboratory findings, and therapy ..
  9. Mwaba P, Mwansa J, Chintu C, Pobee J, Scarborough M, Portsmouth S, et al. Clinical presentation, natural history, and cumulative death rates of 230 adults with primary cryptococcal meningitis in Zambian AIDS patients treated under local conditions. Postgrad Med J. 2001;77:769-73 pubmed
    ..define the natural history, clinical presentation, and management outcome of microbiologically confirmed cryptococcal meningitis in adult AIDS patients treated under local conditions where antifungal and antiretroviral therapies are ..

More Information

Publications79

  1. Sloan D, Dedicoat M, Lalloo D. Treatment of cryptococcal meningitis in resource limited settings. Curr Opin Infect Dis. 2009;22:455-63 pubmed publisher
    b>Cryptococcal meningitis most commonly occurs in advanced HIV. Although diminishing in the developed world with antiretroviral therapy (ART), it remains a major problem in resource-limited settings...
  2. Chretien F, Lortholary O, Kansau I, Neuville S, Gray F, Dromer F. Pathogenesis of cerebral Cryptococcus neoformans infection after fungemia. J Infect Dis. 2002;186:522-30 pubmed
    ..strengthening the hypothesis that monocytes and endothelial cells play key roles in the pathogenesis of cryptococcal meningitis. Similar fungal loads and cellular reactions were seen in mice and in 1 patient with acquired immune ..
  3. Longley N, Muzoora C, Taseera K, Mwesigye J, Rwebembera J, Chakera A, et al. Dose response effect of high-dose fluconazole for HIV-associated cryptococcal meningitis in southwestern Uganda. Clin Infect Dis. 2008;47:1556-61 pubmed publisher
    Therapy for human immunodeficiency virus (HIV)-associated cryptococcal meningitis in many centers in Africa is fluconazole administered at a dosage of 400-800 mg per day...
  4. Larsen R, Pappas P, Perfect J, Aberg J, Casadevall A, Cloud G, et al. Phase I evaluation of the safety and pharmacokinetics of murine-derived anticryptococcal antibody 18B7 in subjects with treated cryptococcal meningitis. Antimicrob Agents Chemother. 2005;49:952-8 pubmed
    A promising approach to improving outcomes in patients with cryptococcal meningitis is to use adjunctive passive immunotherapy with a monoclonal antibody (MAb) directed against the capsular polysaccharide of Cryptococcus neoformans...
  5. Chang W, Lu C, Chang H, Lui C, Tsai N, Huang C, et al. Time course of cerebral hemodynamics in cryptococcal meningitis in HIV-negative adults. Eur J Neurol. 2007;14:770-6 pubmed
    To evaluate the cerebral hemodynamics in cryptococcal meningitis (CM) patients using non-invasive studies...
  6. Almeida A, Matsumoto M, Baeza L, de Oliveira E Silva R, Kleiner A, Melhem M, et al. Molecular typing and antifungal susceptibility of clinical sequential isolates of Cryptococcus neoformans from Sao Paulo State, Brazil. FEMS Yeast Res. 2007;7:152-64 pubmed
    ..neoformans, including four Cryptococcus gattii isolates, obtained from 38 Sao Paulo AIDS patients with cryptococcal meningitis were assessed by electrophoretic karyotyping and random amplified polymorphic DNA (RAPD) analysis...
  7. Vakis A, Koutentakis D, Karabetsos D, Ntouros D. Intracerebral CSF collection mimicking cerebral abscess in a patient suffering from cryptococcal meningitis. J Infect. 2005;51:e233-5 pubmed
    ..of the catheter of an ommaya-type reservoir (Medtronic 12 mm), implanted in a patient suffered from cryptococcal meningitis in the frame of CLL...
  8. Antinori S, Radice A, Galimberti L, Magni C, Fasan M, Parravicini C. The role of cryptococcal antigen assay in diagnosis and monitoring of cryptococcal meningitis. J Clin Microbiol. 2005;43:5828-9 pubmed
  9. Chau T, Mai N, Phu N, Nghia H, Chuong L, Sinh D, et al. A prospective descriptive study of cryptococcal meningitis in HIV uninfected patients in Vietnam - high prevalence of Cryptococcus neoformans var grubii in the absence of underlying disease. BMC Infect Dis. 2010;10:199 pubmed publisher
    Most cases of cryptococcal meningitis occur in patients with HIV infection: the course and outcome of disease in the apparently immunocompetent is much more poorly understood...
  10. Hoque R, Gonzalez Toledo E, Jaffe S. Cryptococcal meningitis presenting as pseudosubarachnoid hemorrhage. South Med J. 2008;101:1255-7 pubmed publisher
    ..He was diagnosed with pseudosubarachnoid hemorrhage secondary to cryptococcal meningitis and choroidal microabscesses with retinal inflammation after a cerebrospinal fluid (CSF) examination ..
  11. Manosuthi W, Chottanapund S, Sungkanuparph S. Mortality rate of early versus deferred initiation of antiretroviral therapy in HIV-1-infected patients with cryptococcal meningitis. J Acquir Immune Defic Syndr. 2008;48:508-9 pubmed publisher
  12. Orem J, Tindyebwa L, Twinoweitu O, Mukasa B, Tomberland M, Mbidde E. Feasibility study of serial lumbar puncture and acetazolamide combination in the management of elevated cerebrospinal fluid pressure in AIDS patients with cryptococcal meningitis in Uganda. Trop Doct. 2005;35:19-21 pubmed
    ..combination in managing raised cerebrospinal fluid pressure was undertaken in 18 patients with AIDS and cryptococcal meningitis in Uganda...
  13. Lortholary O. Management of cryptococcal meningitis in AIDS: the need for specific studies in developing countries. Clin Infect Dis. 2007;45:81-3 pubmed
  14. Netea M, Brouwer A, Hoogendoorn E, Van der Meer J, Koolen M, Verweij P, et al. Two patients with cryptococcal meningitis and idiopathic CD4 lymphopenia: defective cytokine production and reversal by recombinant interferon- gamma therapy. Clin Infect Dis. 2004;39:e83-7 pubmed
    ..Activation of cellular immunity by proinflammatory cytokines plays a central role in anticryptococcal defense...
  15. Angstwurm K, Sokolowska Koehler W, Stadelmann C, Schielke E, Weber J. Fulminant cryptococcal meningitis as presenting feature in a patient with AIDS. Eur J Neurol. 2004;11:353-4 pubmed
  16. Illnait Zaragozí M, Martínez Machín G, Fernández Andreu C, Hagen F, Boekhout T, Klaassen C, et al. Microsatellite typing and susceptibilities of serial Cryptococcus neoformans isolates from Cuban patients with recurrent cryptococcal meningitis. BMC Infect Dis. 2010;10:289 pubmed publisher
    ..We studied C. neoformans isolates from 7 Cuban patients with recurrent cryptococcal meningitis. Antifungal susceptibility and genotyping with microsatellite molecular typing were carried out.
  17. Seboxa T, Alemu S, Assefa A, Asefa A, Diro E. Cryptococcal meningitis in patients with acquired immunudeficiency syndrome in prehaart era at Gondar College of Medical Sciences Hospital north-west Ethiopia. Ethiop Med J. 2010;48:237-41 pubmed
    ..CIyptococcal meningitis is an important opportunistic funimgal infection that became very common after the era of HIV infection...
  18. Lu C, Chang W, Chang H, Chung K, Tsai N, Lui C, et al. Clinical relevance of intracranial arterial stenoses in tuberculous and cryptococcal meningitis. Infection. 2007;35:359-63 pubmed
    Tuberculous and cryptococcal meningitis are two of the most common types of chronic meningitis...
  19. Bicanic T, Harrison T, Niepieklo A, Dyakopu N, Meintjes G. Symptomatic relapse of HIV-associated cryptococcal meningitis after initial fluconazole monotherapy: the role of fluconazole resistance and immune reconstitution. Clin Infect Dis. 2006;43:1069-73 pubmed
    b>Cryptococcal meningitis (CM) in South Africa is often treated with fluconazole as initial therapy...
  20. Hoffmann M, Muniz J, Carroll E, De Villasante J. Cryptococcal meningitis misdiagnosed as Alzheimer's disease: complete neurological and cognitive recovery with treatment. J Alzheimers Dis. 2009;16:517-20 pubmed publisher
    ..dysexecutive syndrome and brain imaging notable for leptomeningeal enhancement; laboratory data confirmed cryptococcal meningitis. Four months after treatment, the patient was normal neurologically, cognitively and neuroradiologically...
  21. Nierenberg N, Thompson G, Lewis J, Hogan B, Patterson T. Voriconazole use and pharmacokinetics in combination with interferon-gamma for refractory cryptococcal meningitis in a patient receiving low-dose ritonavir. Med Mycol. 2010;48:532-6 pubmed publisher
    We present a case of relapsing cryptococcal meningitis unresponsive to standard therapy...
  22. Zhu L, Wu J, Xu B, Ou X, Zhang Q, Weng X. Cryptococcal meningitis in non-HIV-infected patients in a Chinese tertiary care hospital, 1997-2007. Med Mycol. 2010;48:570-9 pubmed publisher
    Information remains sparse about non-HIV patients with cryptococcal meningitis in the era of triazole therapy. Particularly of interest are the clinical manifestations and prognosis of the infection in these previously healthy patients...
  23. Makadzange A, Ndhlovu C, Takarinda K, Reid M, Kurangwa M, Gona P, et al. Early versus delayed initiation of antiretroviral therapy for concurrent HIV infection and cryptococcal meningitis in sub-saharan Africa. Clin Infect Dis. 2010;50:1532-8 pubmed publisher
    BACKGROUND. Cryptococcal meningitis (CM) remains a leading cause of acquired immunodeficiency syndrome-related death in sub-Saharan Africa...
  24. van Toorn R, Kritzinger F, Rabie H. Acute demyelinating encephalomyelitis (ADEM), cryptococcal reactivation and disseminated Herpes simplex in an HIV infected child following HAART. Eur J Paediatr Neurol. 2005;9:355-9 pubmed
    ..We describe a 7-year-old HIV infected child (CD4=10, viral load =180,669copies/ml) who develops a cryptococcal meningitis, with raised intracranial pressure, complicated by ADEM and disseminated Herpes simplex infection ..
  25. Woodworth G, McGirt M, Williams M, Rigamonti D. The use of ventriculoperitoneal shunts for uncontrollable intracranial hypertension without ventriculomegally secondary to HIV-associated cryptococcal meningitis. Surg Neurol. 2005;63:529-31; discussion 531-2 pubmed
    ..CSF infection have historically discouraged surgeons from implanting CSF shunts in patients with HIV and cryptococcal meningitis. However, this patient population often requires frequent lumbar punctures to manage elevated ..
  26. Sar B, Monchy D, Vann M, Keo C, Sarthou J, Buisson Y. Increasing in vitro resistance to fluconazole in Cryptococcus neoformans Cambodian isolates: April 2000 to March 2002. J Antimicrob Chemother. 2004;54:563-5 pubmed
    b>Cryptococcal meningitis is the third-most-common opportunistic infection in HIV patients in Cambodia. Hospitalized patients were given amphotericin B for initial therapy followed by fluconazole for maintenance therapy...
  27. Brouwer A, Teparrukkul P, Pinpraphaporn S, Larsen R, Chierakul W, Peacock S, et al. Baseline correlation and comparative kinetics of cerebrospinal fluid colony-forming unit counts and antigen titers in cryptococcal meningitis. J Infect Dis. 2005;192:681-4 pubmed
    ..unit counts and CSF cryptococcal antigen titers serve as alternative measures of organism load in cryptococcal meningitis. For these measures, we correlated baseline values and rates of decline during the first 2 weeks of ..
  28. French N, Gray K, Watera C, Nakiyingi J, Lugada E, Moore M, et al. Cryptococcal infection in a cohort of HIV-1-infected Ugandan adults. AIDS. 2002;16:1031-8 pubmed
  29. Nussbaum J, Jackson A, Namarika D, Phulusa J, Kenala J, Kanyemba C, et al. Combination flucytosine and high-dose fluconazole compared with fluconazole monotherapy for the treatment of cryptococcal meningitis: a randomized trial in Malawi. Clin Infect Dis. 2010;50:338-44 pubmed publisher
    b>Cryptococcal meningitis is a major cause of human immunodeficiency virus (HIV)-associated morbidity and mortality in Africa...
  30. Costa M, Souza J, Oliveira Neto A, Pinto E Silva J. Cryptococcal meningitis in HIV negative pregnant women: case report and review of literature. Rev Inst Med Trop Sao Paulo. 2009;51:289-94 pubmed
    ..However, there are case reports of cryptococcal meningitis in immune competent pregnant women...
  31. Liou J, Chiu C, Tseng C, Chi C, Fu L. Cryptococcal meningitis in pediatric systemic lupus erythematosus. Mycoses. 2003;46:153-6 pubmed
    b>Cryptococcal meningitis is an uncommon but often fatal complication of systemic lupus erythematosus (SLE)...
  32. Seddon J, Mangeya N, Miller R, Corbett E, Ferrand R. Recurrence of cryptococcal meningitis in HIV-infected patients following immune reconstitution. Int J STD AIDS. 2009;20:274-5 pubmed publisher
    Two HIV-infected patients had recurrent cryptococcal meningitis (CM) despite treatment with fluconazole and immune reconstitution with combination antiretroviral therapy (CART)...
  33. Kumar S, Wanchu A, Chakrabarti A, Sharma A, Bambery P, Singh S. Cryptococcal meningitis in HIV infected: experience from a North Indian tertiary center. Neurol India. 2008;56:444-9 pubmed
    b>Cryptococcal meningitis is a common opportunistic infection in Human Immunodeficiency Virus (HIV)-infected individuals. There is little information specifically addressing cryptococcal meningitis in HIV-infected patients from North India.
  34. Jarvis J, Harrison T. HIV-associated cryptococcal meningitis. AIDS. 2007;21:2119-29 pubmed
  35. Pappas P. Managing cryptococcal meningitis is about handling the pressure. Clin Infect Dis. 2005;40:480-2 pubmed
  36. King M, Perlino C, Cinnamon J, Jernigan J. Paradoxical recurrent meningitis following therapy of cryptococcal meningitis: an immune reconstitution syndrome after initiation of highly active antiretroviral therapy. Int J STD AIDS. 2002;13:724-6 pubmed
    ..active antiretroviral therapy in a patient receiving maintenance fluconazole for a previous diagnosis of cryptococcal meningitis. We describe the unusual radiographic and histopathologic findings which are consistent with an immune ..
  37. Hoepelman A, van der Flier M, Coenjaerts F. Dexamethasone downregulates Cryptococcus neoformans-induced vascular endothelial growth factor production: a role for corticosteroids in cryptococcal meningitis?. J Acquir Immune Defic Syndr. 2004;37:1431-2 pubmed
  38. Skiest D, Hester L, Hardy R. Cryptococcal immune reconstitution inflammatory syndrome: report of four cases in three patients and review of the literature. J Infect. 2005;51:e289-97 pubmed
    ..Patients with cryptococcal disease who initiate HAART are at risk for cryptococcal IRIS...
  39. Kisenge P, Hawkins A, Maro V, McHele J, Swai N, Mueller A, et al. Low CD4 count plus coma predicts cryptococcal meningitis in Tanzania. BMC Infect Dis. 2007;7:39 pubmed
    Largely due to the lack of diagnostic reagents, the prevalence and clinical presentation of cryptococcal meningitis in Tanzania is poorly understood. This in turn is limiting the impact of increased fluconazole availability.
  40. Manosuthi W, Sungkanuparph S, Chottanapund S, Tansuphaswadikul S, Chimsuntorn S, Limpanadusadee P, et al. Temporary external lumbar drainage for reducing elevated intracranial pressure in HIV-infected patients with cryptococcal meningitis. Int J STD AIDS. 2008;19:268-71 pubmed publisher
    ..external lumbar drainage for continuous release of cerebrospinal fluid among patients with HIV-associated cryptococcal meningitis and elevated intracranial pressure (ICP)...
  41. Coenjaerts F, van der Flier M, Mwinzi P, Brouwer A, Scharringa J, Chaka W, et al. Intrathecal production and secretion of vascular endothelial growth factor during Cryptococcal Meningitis. J Infect Dis. 2004;190:1310-7 pubmed
    Patients with cryptococcal meningitis (CM) show elevated intracranial pressure (ICP) and blood-brain barrier (BBB) disruption in most cases. Elevated ICP is an important contributor to mortality...
  42. Bisson G, Nthobatsong R, Thakur R, Lesetedi G, Vinekar K, Tebas P, et al. The use of HAART is associated with decreased risk of death during initial treatment of cryptococcal meningitis in adults in Botswana. J Acquir Immune Defic Syndr. 2008;49:227-9 pubmed publisher
    The objective of this study was to evaluate outcomes among adults with a first episode of cryptococcal meningitis (CM), comparing those on highly active antiretroviral therapy (HAART) with those not on HAART.
  43. Troncoso A, Fumagalli J, Shinzato R, Gulotta H, Toller M, Bava J. CNS cryptococcoma in an HIV-positive patient. J Int Assoc Physicians AIDS Care (Chic). 2002;1:131-3 pubmed
    ..He had a lumbar puncture, and was treated for cryptococcal meningitis. Subsequent brain CT scanning and MRI disclosed a mass lesion in the occipital lobe...
  44. Bouffard J, Mena H, Ripple M, Troncoso J. Mesencephalic cryptococcal abscesses presenting with parkinsonism as an initial manifestation of AIDS. Mov Disord. 2003;18:1354-7 pubmed
    ..Movement disorders in association with AIDS and mesencephalic mass lesions are discussed...
  45. Bicanic T, Wood R, Bekker L, Darder M, Meintjes G, Harrison T. Antiretroviral roll-out, antifungal roll-back: access to treatment for cryptococcal meningitis. Lancet Infect Dis. 2005;5:530-1 pubmed
  46. Boulware D, Bonham S, Meya D, Wiesner D, Park G, Kambugu A, et al. Paucity of initial cerebrospinal fluid inflammation in cryptococcal meningitis is associated with subsequent immune reconstitution inflammatory syndrome. J Infect Dis. 2010;202:962-70 pubmed publisher
    b>Cryptococcal meningitis (CM)-related immune reconstitution inflammatory syndrome (IRIS) complicates antiretroviral therapy (ART) in 20%-40% of ART-naive persons with AIDS and prior CM. Pathogenesis is unknown...
  47. Hamill R, Sobel J, El Sadr W, Johnson P, Graybill J, JAVALY K, et al. Comparison of 2 doses of liposomal amphotericin B and conventional amphotericin B deoxycholate for treatment of AIDS-associated acute cryptococcal meningitis: a randomized, double-blind clinical trial of efficacy and safety. Clin Infect Dis. 2010;51:225-32 pubmed publisher
    BACKGROUND. It is generally acknowledged that amphotericin B is the most effective treatment for cryptococcal meningitis. However, administration of this drug is accompanied by substantial adverse effects...
  48. York J, Bodi I, Reeves I, Riordan Eva P, Easterbrook P. Raised intracranial pressure complicating cryptococcal meningitis: immune reconstitution inflammatory syndrome or recurrent cryptococcal disease?. J Infect. 2005;51:165-71 pubmed
    We report the case of a patient with advanced HIV disease and cryptococcal meningitis, who after an initially good clinical and mycological response to systemic anti-fungal treatment developed symptomatic raised intracranial pressure 10 ..
  49. Bekondi C, Bernede C, Passone N, Minssart P, Kamalo C, Mbolidi D, et al. Primary and opportunistic pathogens associated with meningitis in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus. Int J Infect Dis. 2006;10:387-95 pubmed
    ..To determine the causative organisms and characteristics of patients presenting with meningitis in Bangui in order to provide guidance to physicians for case management...
  50. Liliang P, Liang C, Chang W, Chen H, Su T, Lu K, et al. Shunt surgery for hydrocephalus complicating cryptococcal meningitis in human immunodeficiency virus-negative patients. Clin Infect Dis. 2003;37:673-8 pubmed
    From 1988 through 2001, 27 patients with cryptococcal meningitis who had hydrocephalus were identified and were treated by placement of ventriculoperitoneal (VP) shunts...
  51. Tiamkao S, Sawanyawisuth K, Chotmongkol V. Seizure in non-HIV cryptococcal meningitis. J Med Assoc Thai. 2007;90:1298-302 pubmed
    The authors studied the prevalence of seizure in non-HIV cryptococcal meningitis.
  52. Kwok S, Seo S, Ju J, Yoon C, Park S, Kim B, et al. Cryptococcal meningitis presenting with isolated sixth cranial nerve palsy in a patient with systemic lupus erythematosus. J Korean Med Sci. 2008;23:153-5 pubmed publisher
    b>Cryptococcal meningitis is a rare complication of systemic lupus erythematosus (SLE)...
  53. Larsen R, Bauer M, Brouwer A, Sanchez A, Thomas A, Rajanuwong A, et al. In vitro-clinical correlations for amphotericin B susceptibility in AIDS-associated cryptococcal meningitis. Antimicrob Agents Chemother. 2007;51:343-5 pubmed
    ..In vitro susceptibility employed a modified broth macrodilution method. We demonstrate a strong correlation between the quantitative measures of in vitro amphotericin B susceptibility and the quantitative response observed in patients...
  54. Newton P, Thai L, Tip N, Short J, Chierakul W, Rajanuwong A, et al. A randomized, double-blind, placebo-controlled trial of acetazolamide for the treatment of elevated intracranial pressure in cryptococcal meningitis. Clin Infect Dis. 2002;35:769-72 pubmed
    We conducted a trial of oral acetazolamide for the treatment of cryptococcal meningitis in 22 Thai adults with headache and an opening cerebrospinal fluid pressure of >/=200 mm H(2)0...
  55. Satishchandra P, Mathew T, Gadre G, Nagarathna S, Chandramukhi A, Mahadevan A, et al. Cryptococcal meningitis: clinical, diagnostic and therapeutic overviews. Neurol India. 2007;55:226-32 pubmed
    b>Cryptococcal meningitis has emerged as a leading cause of infectious morbidity and mortality in patients with AIDS...
  56. Wu G, Vilchez R, Eidelman B, Fung J, Kormos R, Kusne S. Cryptococcal meningitis: an analysis among 5,521 consecutive organ transplant recipients. Transpl Infect Dis. 2002;4:183-8 pubmed
    b>Cryptococcal meningitis has been reported to be an important cause of morbidity and mortality in renal transplant recipients...
  57. Chottanapund S, Singhasivanon P, Kaewkungwal J, Chamroonswasdi K, Manosuthi W. Survival time of HIV-infected patients with cryptococcal meningitis. J Med Assoc Thai. 2007;90:2104-11 pubmed
    To study survival time and risk factors of mortality among HIV-infected patients who had cryptococcal meningitis.
  58. Pukkila Worley R, Mylonakis E. Epidemiology and management of cryptococcal meningitis: developments and challenges. Expert Opin Pharmacother. 2008;9:551-60 pubmed publisher
    ..was to outline the worldwide significance of cryptococcosis and review developments in the management of cryptococcal meningitis. Cryptococcus neoformans var...
  59. Othman N, Abdullah N, Wahab Z. Cryptococcal meningitis in an immunocompetent child: a case report and literature review. Southeast Asian J Trop Med Public Health. 2004;35:930-4 pubmed
    ..Further immunological tests did not reveal any defect in the cell-mediated immune system. C. neoformans meningitis may present with non-specific symptoms and should be considered in a work-up for pyrexia of unknown origin...
  60. Cole S, Ledford D, Lockey R, Daas A, Kooper J. Primary gastrointestinal lymphangiectasia presenting as cryptococcal meningitis. Ann Allergy Asthma Immunol. 2007;98:490-2 pubmed
    ..b>Cryptococcal meningitis is a fatal condition if untreated and is usually found in patients with cellular immunodeficiency.
  61. Zahra L, Azzopardi C, Scott G. Cryptococcal meningitis in two apparently immunocompetent Maltese patients. Mycoses. 2004;47:168-73 pubmed
    Two cases of cryptococcal meningitis occurring in immunocompetent men are described...
  62. Sungkanuparph S, Filler S, Chetchotisakd P, Pappas P, Nolen T, Manosuthi W, et al. Cryptococcal immune reconstitution inflammatory syndrome after antiretroviral therapy in AIDS patients with cryptococcal meningitis: a prospective multicenter study. Clin Infect Dis. 2009;49:931-4 pubmed publisher
    ..Of 101 AIDS patients with cryptococcal meningitis who received highly active antiretroviral therapy (HAART), 13 experienced cryptococcal IRIS...
  63. Bicanic T, Muzoora C, Brouwer A, Meintjes G, Longley N, Taseera K, et al. Independent association between rate of clearance of infection and clinical outcome of HIV-associated cryptococcal meningitis: analysis of a combined cohort of 262 patients. Clin Infect Dis. 2009;49:702-9 pubmed publisher
    Progress in therapy for cryptococcal meningitis has been slow because of the lack of a suitable marker of treatment response...
  64. Leite A, Vidal J, Bonasser Filho F, Nogueira R, Oliveira A. Cerebral infarction related to cryptococcal meningitis in an HIV-infected patient: case report and literature review. Braz J Infect Dis. 2004;8:175-9 pubmed
    ..most common causes of cerebral infarction in AIDS are central nervous system infections: toxoplasmosis, cryptococcal meningitis and tuberculosis...
  65. Schaars C, Meintjes G, Morroni C, Post F, Maartens G. Outcome of AIDS-associated cryptococcal meningitis initially treated with 200 mg/day or 400 mg/day of fluconazole. BMC Infect Dis. 2006;6:118 pubmed
    AIDS-associated cryptococcal meningitis has a high mortality. Fluconazole was the only systemic antifungal therapy available in our centre...
  66. Ross J, Katz J. Cryptococcal meningitis and sarcoidosis. Scand J Infect Dis. 2002;34:937-9 pubmed
    This report describes a patient with cryptococcal meningitis and newly diagnosed sarcoidosis not taking corticosteroids...
  67. Makombe S, Nkhata A, Schouten E, Kamoto K, Harries A. Burden of cryptococcal meningitis in Malawi. Trop Doct. 2009;39:32-4 pubmed publisher
    There is little information about the national burden of cryptococcal meningitis (CM) in African countries affected by the HIV/AIDS epidemic...
  68. Sungkanuparph S, Jongwutiwes U, Kiertiburanakul S. Timing of cryptococcal immune reconstitution inflammatory syndrome after antiretroviral therapy in patients with AIDS and cryptococcal meningitis. J Acquir Immune Defic Syndr. 2007;45:595-6 pubmed
  69. Siddiqui A, Brouwer A, Wuthiekanun V, Jaffar S, Shattock R, Irving D, et al. IFN-gamma at the site of infection determines rate of clearance of infection in cryptococcal meningitis. J Immunol. 2005;174:1746-50 pubmed
    ..fluid (CSF) fungal cultures in 62 patients in a trial of antifungal therapy for HIV-associated cryptococcal meningitis. CSF IL-6, IFN-gamma, TNF-alpha, and IL-8 were significantly higher in survivors compared with ..
  70. Xia R, Hu Z, Sun Y, Chen S, Gu M, Zhou Y, et al. Overexpression of beta-arrestin 2 in peripheral blood mononuclear cells of patients with cryptococcal meningitis. J Interferon Cytokine Res. 2010;30:155-62 pubmed publisher
    b>Cryptococcal meningitis is often associated with elevated IL-10 levels, which suggest a dysregulation in the antifungal immune response...