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Meningitis in HIV

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Predictors of outcome in childhood Plasmodium falciparum malaria.

Harsita Patel, Claire Dunican, Aubrey J Cunnington,

Plasmodium falciparum malaria is classified as either uncomplicated or severe, determining clinical management and providing a framework for understanding pathogenesis. Severe malaria in children is defined by the presence of one or more features associated with adverse outcome, but there is wide variation in the predictive value of these features. ... Read more >>

Virulence (Virulence)
[2020, 11(1):199-221]

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Ventriculoperitoneal shunt insertion in human immunodeficiency virus infected adults: a systematic review and meta-analysis

James Loan, Michael Poon, Steven Tominey, Ncedile Mankahla, Graeme Meintjes, Graham Fieggen,

<title>Abstract</title> <p> Background Hydrocephalus is a common, life threatening complication of human immunodeficiency virus (HIV)-related central nervous system opportunistic infection which can be treated by insertion of a ventriculoperitoneal shunt (VPS). In HIV-infected patients there is concern that VPS might be associated with unacceptably high mortality. To identify ... Read more >>

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Cryptococcosis in pregnancy and the postpartum period: Case series and systematic review with recommendations for management.

Katelyn A Pastick, Elizabeth Nalintya, Lillian Tugume, Kenneth Ssebambulidde, Nicole Stephens, Emily E Evans, Jane Frances Ndyetukira, Edwin Nuwagira, Caleb Skipper, Conrad Muzoora, David B Meya, Joshua Rhein, David R Boulware, Radha Rajasingham,

Cryptococcal meningitis causes 15% of AIDS-related deaths. Optimal management and clinical outcomes of pregnant women with cryptococcosis are limited to case reports, as pregnant women are often excluded from research. Amongst pregnant women with asymptomatic cryptococcosis, no treatment guidelines exist. We prospectively identified HIV-infected women who were pregnant or recently ... Read more >>

Med. Mycol. (Medical mycology)
[2020, 58(3):282-292]

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Tuberculosis in HIV-Associated Cryptococcal Meningitis is Associated with an Increased Risk of Death.

Morris K Rutakingirwa, Fiona V Cresswell, Richard Kwizera, Kenneth Ssebambulidde, Enock Kagimu, Edwin Nuwagira, Lillian Tugume, Edward Mpoza, Joanna Dobbin, Darlisha A Williams, Conrad Muzoora, David B Meya, David R Boulware, Kathy H Hullsiek, Joshua Rhein,

Tuberculosis (TB) and cryptococcal meningitis are leading causes of morbidity and mortality in advanced HIV disease. Data are limited on TB co-infection among individuals with cryptococcal meningitis. We performed a retrospective analysis of HIV-infected participants with cryptococcal meningitis from 2010-2017. Baseline demographics were compared between three groups: 'prevalent TB' if ... Read more >>

J Clin Med (Journal of clinical medicine)
[2020, 9(3):]

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Assessing the virulence of Cryptococcus neoformans causing meningitis in HIV infected and uninfected patients in Vietnam.

Lam Tuan Thanh, Dena L Toffaletti, Jennifer L Tenor, Charles Giamberardino, Gregory D Sempowski, Yohannes Asfaw, Hai Trieu Phan, Anh Van Duong, Nguyen Mai Trinh, Guy E Thwaites, Philip M Ashton, Nguyen Va Vinh Chau, Stephen G Baker, John R Perfect, Jeremy N Day,

We previously observed a substantial burden of cryptococcal meningitis in Vietnam atypically arising in individuals who are uninfected with human immunodeficiency virus (HIV). This disease was associated with a single genotype of Cryptococcus neoformans (sequence type [ST]5), which was significantly less common in HIV-infected individuals. Aiming to compare the phenotypic ... Read more >>

Med. Mycol. (Medical mycology)
[2020, :]

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B Cell Compartmentalization in Blood and Cerebrospinal Fluid of HIV-Infected Ugandans with Cryptococcal Meningitis.

Samuel Okurut, David B Meya, Freddie Bwanga, Joseph Olobo, Michael A Eller, Fatim Cham-Jallow, Paul R Bohjanen, Harsh Pratap, Brent E Palmer, Katharine H Hullsiek, Yukari C Manabe, David R Boulware, Edward N Janoff,

Activated B cells modulate infection by differentiating into pathogen-specific antibody-producing effector plasmablasts/plasma cells, memory cells, and immune regulatory B cells. In this context, the B cell phenotypes that infiltrate the central nervous system during human immunodeficiency virus (HIV) and cryptococcal meningitis coinfection are ill defined. We characterized clinical parameters, mortality, ... Read more >>

Infect. Immun. (Infection and immunity)
[2020, 88(3):]

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Cost-effectiveness of reflex laboratory-based cryptococcal antigen screening for the prevention and treatment of cryptococcal meningitis in Botswana

Mark Tenforde, Charles Muthoga, Andrew Callaghan, Ponego Ponatshego, Julia Ngidi, Madisa Mine, Alexander Jordan, Tom Chiller, Bruce Larson, Joseph Jarvis,

Background: Cryptococcal antigen (CrAg) screening for antiretroviral therapy (ART)-naïve adults with advanced HIV/AIDS can reduce the incidence of cryptococcal meningitis (CM) and all-cause mortality. We modeled the cost-effectiveness of laboratory-based “reflex” CrAg screening for ART-naïve CrAg-positive patients with CD4<100 cells/µL (those currently targeted in guidelines) and ART-experienced CrAg-positive patients with ... Read more >>

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The prevalence of cryptococcal antigen (CrAg) and benefits of pre-emptive antifungal treatment among HIV-infected persons with CD4+ T-cell counts < 200 cells/μL: Evidence based on a meta-analysis

Yaokai Chen, Yao Li, Xiaojie Huang, Hui Chen, Yuanyuan Qin, Jianhua Hou, Aixin Li, Hao Wu, Xiaofeng Yan,

<title>Abstract</title> <p> Background: Current WHO guidelines (2018) recommend screening for cryptococcal antigen (CrAg) in HIV-infected persons with CD4<100 cells/μL, followed by pre-emptive antifungal therapy among CrAg positive (CrAg+) persons, to prevent Cryptococcal meningitis related deaths. The strategy may also be considered for those persons with a CD4 count ... Read more >>

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What is AIDS in the Amazon and the Guianas in the 90-90-90 era?

Mathieu Nacher, Antoine Adenis, Basma Guarmit, Aude Lucarelli, Denis Blanchet, Magalie Demar, Felix Djossou, Philippe Abboud, Loïc Epelboin, Pierre Couppié,

Introduction In the past decade, new diagnostic methods and strategies have appeared, HIV testing efforts and the generalization of antiretroviral therapy may have influenced the number of opportunistic diagnoses and mortality of HIV-infected patients. To test this hypothesis we compiled data on the top opportunistic infections and causes of early ... Read more >>

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Evaluation of Serum Cryptococcal Antigen Testing Using Two Novel Semiquantitative Lateral Flow Assays in Persons with Cryptococcal Antigenemia.

Caleb Skipper, Kiiza Tadeo, Emily Martyn, Elizabeth Nalintya, Radha Rajasingham, David B Meya, Bosco Kafufu, Joshua Rhein, David R Boulware,

Early cryptococcal disease can be detected via circulating antigen in blood before fulminant meningitis develops, when early antifungal therapy improves survival. Two semiquantitative cryptococcal antigen (CrAg) lateral flow assays (LFAs) have been developed, but their diagnostic performance has not been defined. Cryopreserved serum samples from HIV-infected Ugandans obtained as part ... Read more >>

J. Clin. Microbiol. (Journal of clinical microbiology)
[2020, 58(4):]

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Prevalence and mortality of cryptococcal disease in adults with advanced HIV in an urban tertiary hospital in Sierra Leone: a prospective study.

Sulaiman Lakoh, Hannah Rickman, Momodu Sesay, Sartie Kenneh, Rachael Burke, Mamadu Baldeh, Darlinda F Jiba, Yusuf S Tejan, Sonia Boyle, Comfort Koroma, Gibrilla F Deen, Fenella Beynon,

BACKGROUND:The global annual estimate for cryptococcal disease-related deaths exceeds 180,000, with three fourth occurring in sub-Saharan Africa. The World Health Organization (WHO) recommends cryptococcal antigen (CrAg) screening in all HIV patients with CD4 count < 100/μl. As there is no previous published study on the burden and impact of cryptococcal disease ... Read more >>

BMC Infect. Dis. (BMC infectious diseases)
[2020, 20(1):141]

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An unusual presentation of gross cerebral vascular dilatation in a TB/HIV co-infected individual.

Matthew Laurence Fielies, Iain Scott Walker,

Aneurysmal dilatation secondary to HIV vasculitis is well described being more common in patients under 45 years of age with advanced stage HIV infection (CD4 < 200 cells/µl). Tuberculous meningitis is far more common than previously anticipated with centres in Cape Town publishing that more than half of all cases of adult meningitis ... Read more >>

Br J Neurosurg (British journal of neurosurgery)
[2020, :1-4]

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HIV-Associated Histoplasmosis: Current Perspectives.

Thein Myint, Nicole Leedy, Evelyn Villacorta Cari, L Joseph Wheat,

AbstractHistoplasmosis is an endemic mycosis caused by Histoplasma capsulatum. Infection develops by inhalation of microconidia from environmental sites inhabited by birds and bats. Disseminated disease is the usual presentation due to impaired cellular immunity. Common clinical manifestations include fever, fatigue, malaise, anorexia, weight loss, and respiratory symptoms. Histoplasma antigen detection ... Read more >>

HIV AIDS (Auckl) (HIV/AIDS (Auckland, N.Z.))
[2020, 12:113-125]

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Cryptococcal antigenemia and its predictors among HIV infected patients in resource limited settings: a systematic review

Awoke Derbie, Daniel Mekonnen, Yimtubezinash Woldeamanuel, Tamrat Abebe,

<title>Abstract</title> <p> Background: Cryptococcosis is an opportunistic fungal infection that primarily affects people with advanced HIV/AIDS and is an important cause of morbidity and mortality around the globe. By far the most common presentation of the disease is cryptococcal meningitis (CM), which leads to an estimated 15-20% of ... Read more >>

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Fungal diseases as neglected pathogens: A wake-up call to public health officials.

Marcio L Rodrigues, Joshua D Nosanchuk,

PLoS Negl Trop Dis (PLoS neglected tropical diseases)
[2020, 14(2):e0007964]

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CD8+ T cells target cerebrovasculature in children with cerebral malaria.

Brittany A Riggle, Monica Manglani, Dragan Maric, Kory R Johnson, Myoung-Hwa Lee, Osorio Lopes Abath Neto, Terrie E Taylor, Karl B Seydel, Avindra Nath, Louis H Miller, Dorian B McGavern, Susan K Pierce,

BACKGROUNDCerebral malaria (CM) accounts for nearly 400,000 deaths annually in African children. Current dogma suggests that CM results from infected RBC (iRBC) sequestration in the brain microvasculature and resulting sequelae. Therapies targeting these events have been unsuccessful; findings in experimental models suggest that CD8+ T cells drive disease pathogenesis. However, ... Read more >>

J. Clin. Invest. (The Journal of clinical investigation)
[2020, 130(3):1128-1138]

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CD8+ T cells and human cerebral malaria: a shifting episteme.

Laurent Rénia, Georges Er Grau, Samuel C Wassmer,

Mosquito-transmitted Plasmodium falciparum infection can cause human cerebral malaria (HCM) with high mortality rates. The abundance of infected red blood cells that accumulate in the cerebral vasculature of patients has led to the belief that these brain-sequestered cells solely cause pathogenesis. However, animal models suggest that CD8+ T cells migrate ... Read more >>

J. Clin. Invest. (The Journal of clinical investigation)
[2020, 130(3):1109-1111]

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Cost-effectiveness and budget impact of flucytosine as induction therapy in the treatment of cryptococcal meningitis in HIV-infected adults in South Africa

Jacqui Miot, Trudy Leong, Simbarashe Takuva, Andrew Parrish, Halima Dawood,

<title>Abstract</title> <p> Background Cryptococcal meningitis in HIV-infected patients in sub-Saharan Africa accounts for three-quarters of the global cases and 135 000 deaths per annum. Current treatment includes the use of fluconazole and amphotericin B. Recent evidence has shown that the synergistic use of flucytosine improves efficacy and reduces ... Read more >>

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Clinical, Imaging, and Laboratory Characteristics of Adult Mexican Patients with Tuberculous Meningitis: A Retrospective Cohort Study.

Miguel García-Grimshaw, Francisco Alejandro Gutiérrez-Manjarrez, Samuel Navarro-Álvarez, Alejandra González-Duarte,

Tuberculous Meningitis (TBM) is the most common form of central nervous system Tuberculosis (TB), accounting for 5-6% of extrapulmonary TB cases. Nowadays, TBM continues to be a major topic in public health because of its high prevalence worldwide. This retrospective study aimed to describe the clinical, laboratory, and imaging characteristics ... Read more >>

J Epidemiol Glob Health (Journal of epidemiology and global health)
[2020, 10(1):59-64]

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Escherichia coli: a rare cause of meningitis in immuno-competent adult.

Maryam Zafar, Abubakar Tauseef, Muhammad Sohaib Asghar, Narmin Khan, Nabeeha Farooqui, Mustafa Dawood, Tanvir Alam, Durre Naman,

A 35-year-old male of Asian ethnicity presented with complaints of high-grade fever, severe headache, vomiting, generalized seizures, deteriorated conscious level and neck stiffness. After all baseline workup Computed Tomography (CT) scan of the brain was done, which turned out to be unremarkable. CT scan was then followed by lumbar puncture ... Read more >>

J Community Hosp Intern Med Perspect (Journal of community hospital internal medicine perspectives)
[2020, 10(1):69-72]

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Current burden of serious fungal infections in Republic of Congo.

Fructueux M Amona, David W Denning, Donatien Moukassa, Christophe Hennequin,

BACKGROUND:The Republic of Congo (RoC) is characterized by a high prevalence of tuberculosis and HIV/AIDS, which largely drive the epidemiology of serious fungal infections. OBJECTIVE:We aimed to estimate the current burden of serious fungal infections in RoC. MATERIAL AND METHODS:Using local, regional, or global data and estimates of population and ... Read more >>

Mycoses (Mycoses)
[2020, :]

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Cryptococcal antigenemia is associated with meningitis or death in HIV-infected adults with CD4 100-200 cells/mm3.

James Wykowski, Sean R Galagan, Sabina Govere, Carole L Wallis, Mahomed-Yunus Moosa, Connie Celum, Paul K Drain,

BACKGROUND:Cryptococcal antigen (CrAg) screening with fluconazole prophylaxis has been shown to prevent cryptococcal meningitis and mortality for people living with HIV (PLWH) with CD4 < 100 cells/mm3. While cryptococcal meningitis occurs in individuals with CD4 100-200 cells/mm3, there is limited evidence that CrAg screening predicts cryptococcal meningitis or mortality among this group ... Read more >>

BMC Infect. Dis. (BMC infectious diseases)
[2020, 20(1):61]

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HIV-1 Central Nervous System Compartmentalization and Cytokine Interplay in Non-subtype B HIV-1 Infections in Nigeria and Malawi.

Olubusuyi Moses Adewumi, Elena Dukhovlinova, Nathan Y Shehu, Shuntai Zhou, Olivia D Council, Maxwell O Akanbi, Babafemi Taiwo, Adesola Ogunniyi, Kevin Robertson, Cecilia Kanyama, Mina C Hosseinipour, Ronald Swanstrom,

HIV-1 compartmentalization in the central nervous system (CNS) and its contribution to neurological disease have been well documented. Previous studies were conducted among people infected with subtypes B or C where CNS compartmentalization has been observed when comparing viral sequences in the blood to virus in cerebrospinal fluid (CSF). However, ... Read more >>

AIDS Res. Hum. Retroviruses (AIDS research and human retroviruses)
[2020, :]

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Failure of multiplex meningitis/encephalitis (ME) NAT during cryptococcal meningitis in solid organ recipients.

B Pilmis, M-E Bougnoux, R Guery, Y Senghor, A Le Monnier, F Lanternier, S Bretagne, A Alanio, O Lortholary,

Cryptococcal meningitis is a severe cause of central nervous system infections among immunocompromised solid organ transplant (SOT) patients. While new diagnostic methods as multiplex meningitis/encephalitis (ME) NAT (nucleic acid test) are increasingly used as a first-line tool in hospital practice, data in HIV-negative patients including SOT remain scarce. We report ... Read more >>

Transpl Infect Dis (Transplant infectious disease : an official journal of the Transplantation Society)
[2020, :e13263]

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Neurological worsening during treatment of an immunocompetent adult with Cryptococcus neoformans meningitis.

Singhal Tanu, Munshi Mihir, Soman Rajeev, Aggarwal Annu,

Cryptococcal meningitis is being increasingly described in immunocompetent adults. We describe here a young immuncompetent adult of Indian origin from Ghana, West Africa with cryptococcal meningitis who had several ups and downs during his treatment. First he developed neurologic worsening due to premature transition from intensive to consolidation phase therapy. ... Read more >>

Med Mycol Case Rep (Medical mycology case reports)
[2020, 27:48-51]

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