1/12. Cryptococcal meningitis in pediatric systemic lupus erythematosus.Cryptococcal meningitis is an uncommon but often fatal complication of systemic lupus erythematosus (SLE). We report on a 13-year-old girl with SLE using high-dose prednisolone for several months, presented to us with low grade fever, intermittent vomiting and headache. physical examination, including papilloedema and meningeal irritation, was unremarkable. serum and cerebrospinal fluid (CSF) cryptococcal antigen titer was 1: 128 by latex agglutination method. CSF culture yielded cryptococcus neoformans. We used amphotericin b deoxycholate (a cumulative dose of 1.95 gm) and fluconazole (200 mg day-1) for 6 weeks. Clinical response was good. Then, we continued fluconazole 200 mg per qd as suppressive therapy for thirty-four months. There were no neurological sequelae or relapse after 20-month follow-up. Timely diagnosis and effective antifungal therapy could improve the prognosis of cryptococcal meningitis in SLE patients.- - - - - - - - - - ranking = 1keywords = latex (Clic here for more details about this article) |
2/12. Cryptococcal meningitis in two apparently immunocompetent Maltese patients.Two cases of cryptococcal meningitis occurring in immunocompetent men are described. The first case involves a farmer in whom cryptococcal meningitis was rapidly diagnosed using direct microscopy, latex antigen tests and culture of cerebrospinal fluid (CSF). In the second case, initial mycological tests on CSF (direct microscopy and culture) were repetitively negative and latex antigen tests gave unconvincing results. The patient was started on triple antituberculosis therapy, on which he improved immediately; therapy was continued for 1 year with the patient remaining well. However, within 1 week of stopping therapy, he had to be readmitted with neurological signs and symptoms. culture of CSF this time yielded cryptococcus neoformans and the antigen test was consistently positive. These are the first reported cases of cryptococcal meningitis in immunocompetent patients in malta.- - - - - - - - - - ranking = 2keywords = latex (Clic here for more details about this article) |
3/12. Cryptococcal meningitis in acute lymphoblastic leukemia.The occurrence of cryptococcal meningitis in acute lymphoblastic leukemia (ALL), despite being immunosuppresed state is uncommon. We report a 28-year gentleman in the maintenance treatment phase of ALL developing cryptococcal meningitis. The diagnosis was made by positive india ink staining and detection of cryptola antigen by latex agglutination. The patient was successfully treated with amphotericin b. The rarity of this condition in ALL is briefly discussed.- - - - - - - - - - ranking = 1keywords = latex (Clic here for more details about this article) |
4/12. Low yield of screening for cryptococcal antigen by latex agglutination assay on serum and cerebrospinal fluid from Danish patients with AIDS or ARC.From July 1, 1989 to September 5, 1990, 530 serum specimens and 50 cerebrospinal fluid (CSF) specimens from 334 hiv-1 infected patients, most of whom had AIDS or ARC, were analysed in a cryptococcal antigen latex agglutination assay, and all were negative. Three cases of meningitis due to cryptococcus neoformans diagnosed by microscopy and culture in 3 hiv-1 infected patients are presented. Stored specimens of serum and CSF from these patients were assayed for cryptococcal antigen, and in all 3 the onset of meningitis was preceded by the presence of cryptococcal antigen in serum. It is concluded that the low occurrence of cryptococcosis in our patient population does not justify a routine serum screening for cryptococcal antigen.- - - - - - - - - - ranking = 5keywords = latex (Clic here for more details about this article) |
5/12. latex agglutination test negative cryptococcal meningitis in an immuno-competent individual: a case report.We report a case with progressive mental deterioration and persistent low grade fever, who was diagnosed to have cryptococcal meningitis. This case is unique in that the cryptococcal latex agglutination antigen test was consecutively negative. The diagnosis was made by sequential CSF culture.- - - - - - - - - - ranking = 1keywords = latex (Clic here for more details about this article) |
6/12. Manic episode secondary to cryptococcal meningitis in a previously healthy adult.A case of a manic episode secondary to cryptococcal meningitis is reported. Cryptococcal meningitis is the most common cause of chronic meningitis in adults in papua new guinea and may rarely present with features of functional psychosis. Laboratory investigations on the cerebrospinal fluid such as the india ink smear and fungal culture for the detection of the organism and the latex agglutination test to detect the cryptococcal antigen are invaluable aids for making the correct diagnosis.- - - - - - - - - - ranking = 1keywords = latex (Clic here for more details about this article) |
7/12. False-negative cerebrospinal fluid cryptococcal latex agglutination tests for patients with culture-positive cryptococcal meningitis.Three cases of false-negative cerebrospinal fluid latex agglutination test results for patients with culture-positive cryptococcal meningitis are reported. False-negative results occurred in settings of low cryptococcal antigen concentrations in cerebrospinal fluid and were dependent on the latex agglutination test kit used. Investigation of each case revealed that prozone phenomena or interference from bound antibody or protein could not account for the false-negative results.- - - - - - - - - - ranking = 6keywords = latex (Clic here for more details about this article) |
8/12. serum therapy for Cryptococcal meningitis.Three patients were treated with combined amphotericin b and rabbit anticryptococcal antibody in the 1960s. Rabbit antibody was administered intravenously and was well tolerated. For each patient, administration of rabbit antibody resulted in the appearance of serum cryptococcus neoformans agglutinins. For two patients the administration of rabbit antibody resulted in negative serum latex tests for cryptococcal antigen. This limited experience with adjunctive antibody therapy provides valuable precedents if antibody therapy is used again for treatment of human cryptococcosis.- - - - - - - - - - ranking = 1keywords = latex (Clic here for more details about this article) |
9/12. cryptococcosis associated with HIV negative Indian patients and HIV positive Indian blood donors.cryptococcosis, particularly cryptococcal meningitis (CM), has become an increasing problem globally in the AIDS era. In the present investigation we have made an effort for the first time to study Indian cases (100) both HIV-positive (23 cases, male, mostly Indian professional blood donors, PBDs') confirmed by an ELISA test and Western Blot but asymptomatic for CM and HIV-negative (77:49 male and 28 female) asymptomatic or symptomatic. These subjects were patients from the Lucknow hospitals admitted during the period between February, 1991 to February, 1994, for suspected cryptococcosis or CM. Of those cases, 10% were positive for cryptococcosis or CM. meningoencephalitis was the dominant clinical manifestation in four (HIV-negative) cases of CM. CT scanning of the head of those cases revealed a noncommunicating hydrocephalus due to aqueductal stenosis (in 2 cases) and a communicating hydrocephalus with granuloma (by MRI) in another case. The latex agglutination test (LAT) of the sera was positive for Cryptococcus antigen in 6 (26%) of the (HIV-positive) patients and 4 (5%), of the HIV-negative cases. In the cases of CM, there was a lower antigen titre in CSF than in the pronase-treated sera. The LAT was found to be useful in diagnosis of cryptococcosis, especially in asymptomatic cases. The CSF of CM-positive cases revealed low levels of glucose, reduced cell count and high proteins. Among the HIV-negative cases, the onset of meningitis in 4 cases was preceded by the presence of encapsulated budding yeast cells in CSF india ink smear, or cryptococci in a direct urine smear in one case. The CSF culture of 3 cases was positive for mucoid cryptococcus neoformans, showing brown colour effect (BCE) on Staib agar (syn. Guizotia abyssinica creatinine agar, bird seed agar). The isolated yeast strains were identified as C. neoformans var. neoformans by physiological tests. The pathogenicity test of strains revealed virulence to BALB/c mice evidenced by a high mortality of mice and significantly (p < 0.05) high CN burden (> 4-5 mean log(10) cfu), in the brain followed by other visceral organs (lung, liver, spleen, kidney and heart). The in-vitro susceptibility (MIC mu gmL(-1)) of strains.- - - - - - - - - - ranking = 1keywords = latex (Clic here for more details about this article) |
10/12. intracranial hypertension and cryptococcal meningitis in a girl with AIDS.A girl with HIV infection acquired at birth by blood transfusion, was admitted at the age of 10 years for diplopia, vomiting, headache and papilledema. CT scan was negative. A lumbar puncture revealed clear CSF, protein 0.40 g/l, glucose 2 mmol/l, 5 mononuclear cells/mm3. The Indian ink preparation and the latex agglutination antigen test were positive for Cryptococcus n. Treatment with amphotericin b and flucytosine was started. After 10 days, since the in vitro susceptibility testing of the isolates showed resistence to both drugs, fluconazolo (400 mg/day) was started. acetazolamide, furosemide and spironolactone were then added to the antifungal therapy for the persistence of severe intracranial hypertension. diuretics were maintained for 10 weeks. The patient returned to school two and half months after the admission to the hospital. After 19 months, she is doing well and she is on maintenance of fluconazole (200 mg/day). We hypothesized that the increased intracranial pressure would be due to an impaired CSF reabsorption probably as a consequence of a direct cryptococcal infiltration of the villi.- - - - - - - - - - ranking = 1keywords = latex (Clic here for more details about this article) |
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