In this paper, the crawler, second instar female and male, prepupa, pupa and adult male of Cryptococcus ulmi are described and illustrated for the first time; adult female is redescribed; a key to all stages is gi...In this paper, the crawler, second instar female and male, prepupa, pupa and adult male of Cryptococcus ulmi are described and illustrated for the first time; adult female is redescribed; a key to all stages is given and the biology is briefly repor ted.展开更多
AIM:To report 4 cases of Cryptococcus gattii(C.gattii)species complex infection with diverse ophthalmic manifestations,and to review the literature to examine pathobiology of disease,classical ophthalmic presentations...AIM:To report 4 cases of Cryptococcus gattii(C.gattii)species complex infection with diverse ophthalmic manifestations,and to review the literature to examine pathobiology of disease,classical ophthalmic presentations and outcomes,and treatment modalities for this emerging pathogen.METHODS:Cases of C.gattii meningoencephalitis with ophthalmic manifestations were identified via chart review at two institutions in Australia and one institution in the mid-west region of the United States and are reported as a case series.Additionally,a MEDLINE literature review was conducted to identify all reported cases of C.gattii with ophthalmic manifestations from 1990-2020.Cases were reviewed and tabulated,together with our series of patients,in this report.RESULTS:Four cases of C.gattii with ophthalmic manifestations are presented;three from Australia and one from the USA.A literature review identified a total of 331 cases of C.gattii with visual sequelae.The majority of cases occurred in immunocompetent individuals.Blurred vision and diplopia were the most common presenting symptoms,with papilloedema the most common sign,reported in 10%-50%of cases.Visual loss was reported in 10%-53%of cases,as compared to rates of visual loss of 1%-9%in C.neoformans infection.Elevated intracranial pressure,cerebrospinal fluid(CSF)fungal burden,and abnormal neurological exam at presentation correlated with poor visual outcomes.The mainstays of treatment are anti-fungal agents and aggressive management of intracranial hypertension with serial lumbar punctures.CSF diversion procedures should be considered for refractory cases.Acetazolamide and mannitol are associated with high complication rates,and adjuvant corticosteroids have demonstrated higher mortality rates;these treatments should be avoided.CONCLUSION:Permanent visual loss represents a devastating yet potentially preventable sequelae of C.gattii infection.Intracranial hypertension needs to be recognised early and aggressively managed.Referral to an ophthalmologist/neuro-ophthalmologist in all cases of cryptococcal infection independent of visual symptoms at time of diagnosis is recommended.展开更多
Background: Yeasts from the genus Cryptococcus (species C. neoformans and C. gattii) are opportunistic pathogens that afflict humans with low immunity caused by diseases such as AIDS or by the usage of immunosuppressi...Background: Yeasts from the genus Cryptococcus (species C. neoformans and C. gattii) are opportunistic pathogens that afflict humans with low immunity caused by diseases such as AIDS or by the usage of immunosuppressive drugs. It is a fatal disease that has been studied around the whole world and its most fatal form is the brain cryptococcosis. Purpose: The present review describes the disease from pathogen isolation, the various clinical presentations of the disease, the most important virulence factors of yeast in human and animal model and their clinical issues. Methods: On this review, several published studies about the disease are presented. Results: Numerous researches have been done worldwide in order to find a kind of therapy that is more effective against the disease. Amphotericin B, in all forms is still the drug of choice in the treatment of the cryptococcosis. Fluconazole, as well as voriconazole in combination with amphotericin B, is recommended in the cases of treatment failure. Conclusion: This study presented has elucidated a little more about the disease. Further studies should be conducted to find more diagnoses that are accurate as well as more effective treatments for eradicating the disease. In this study, the bibliographic survey makes reference to the world literature;with regard to ecology, taxonomy, mains factors related to virulence, the clinical manifestations, the action of antifungal drugs and histopathological analysis used in an animal model, were the objectives deleterious aspects of this study, thus informing, in a simple way, the importance of this microorganism for research and researchers working with this global disease, called Cryptococcosis.展开更多
The present study was performed mainly to investigate the antagonist-pathogen-host interaction in wounds of the sweet cherry fruits. The antagonistic yeast Cryptococcus laurentii could significantly reduce the brown r...The present study was performed mainly to investigate the antagonist-pathogen-host interaction in wounds of the sweet cherry fruits. The antagonistic yeast Cryptococcus laurentii could significantly reduce the brown rot of the sweet cherry fruit caused by Monilinia fructicola at 25 and 1 ℃. The populations of yeast increased faster in the presence of the pathogen initially, but then decreased rapidly. In the fruits inoculated with M. fructicola alone or combined with C. laurentii, an induction of lipid peroxidation as well as activities of the antioxidant enzymes, such as, superoxide dismutases (SOD), catalase (CAT), and peroxidase (POD), was observed. The isoenzyme pattern of polypheno/oxidase (PPO) changed greatly after the symptoms appeared, with new PPO isoforms being induced. By contrast, the induction of lipid peroxidation and activities of SOD, CAT, and POD were low, although no significant changes were found in the PPO isoenzyms in the fruits inoculated with antagonist C. laurentii alone. The inhibition of brown rot during the antagonist- pathogen-host interaction in wounds of the sweet cherry fruits was mainly on account of the stimulated growth of C. laurentii as well as the induction of antioxidant enzymes of the fruits by M. fructicola.展开更多
BACKGROUND Cryptococcus presenting as an opportunistic pathogen mainly affects immunocompromised patients,but the disseminated form of infection is rare among immunocompetent populations.The partial radiographic chara...BACKGROUND Cryptococcus presenting as an opportunistic pathogen mainly affects immunocompromised patients,but the disseminated form of infection is rare among immunocompetent populations.The partial radiographic characteristics of pulmonary cryptococcosis mimic lung carcinoma,leading to unnecessary open chest exploratory surgery,and the lack of a gold-standard noninvasive diagnostic increases the risk of misdiagnosis.Positron emission tomography/computed tomography(PET/CT),a sensitive method for distinguishing malignant tumors,coupled with cryptococcal latex agglutination test showing a high positive rate may overcome these issues.CASE A 36-year-old man presented for general examination,without health complaints.Routine CT showed multiple pulmonary nodules and a mass with high maximum standardized uptake value.Initially,we suspected primary malignancy with hematogenous metastasis.Although his routine fungal analysis had been negative,subsequent CT-guided percutaneous core needle biopsy and histopathology examination indicated a diagnosis of pulmonary cryptococcosis.Fluconazole(200 mg/d)antifungal drug treatment was initiated,and 1 mo later the pulmonary mass had reduced in size markedly(on chest CT scan)without any complications.CONCLUSION Serologic and PET/CT examinations may not rule out cryptococcosis,and percutaneous lung puncture is critical under all circumstances.展开更多
We communicate the diagnosis by microscopy of a pulmonary coinfection produced by Cryptococcus neoformans and Pneumocystis jiroveci,from a respiratory secretion obtained by bronchoalveolar lavage of an AIDS patient.Ou...We communicate the diagnosis by microscopy of a pulmonary coinfection produced by Cryptococcus neoformans and Pneumocystis jiroveci,from a respiratory secretion obtained by bronchoalveolar lavage of an AIDS patient.Our review of literature identified this coinfection as unusual presentation.Opportunistic infections associated with HIV infection are increasingly recognized.It may occur at an early stage of HIV-infection.Whereas concurrent opportunistic infections may occur,coexisting Pneumocystis jiroveci pneumonia(PCP)and disseminated cryptococcosis with cryptococcal pneumonia is uncommon.The lungs of individuals infected with HIV are often affected by opportunistic infections and tumours and over two-thirds of patients have at least one respiratory episode during the course of their disease.Pneumonia is the leading HIV-associated infection.We present the case of a man who presented dual Pneumocystis jiroveci and cryptococcal pneumonia in a patient with HIV.Definitive diagnosis of PCP and Cryptococcus requires demonstration of these organisms in pulmonary tissues or fluid.In patients with<200/microliter CD4-lymphocytes,a bronchoalveolar lavage should be performed.This patient was successfully treated with amphotericin B and trimethoprim sulfamethoxazole.After 1 week the patient showed clinical and radiologic improvement and was discharged 3 weeks later.展开更多
Objective: To evaluate anti-Candida and anti-Cryptococcus activities of 15 nonalkaloidal compounds from Pterogyne nitens Tulasne(Leguminosae), a South American medicinal plant.Methods: Compounds were submitted to anti...Objective: To evaluate anti-Candida and anti-Cryptococcus activities of 15 nonalkaloidal compounds from Pterogyne nitens Tulasne(Leguminosae), a South American medicinal plant.Methods: Compounds were submitted to antifungal assays, using microdilution method described by Clinical and Laboratory Standards Institute document, with minor modifications. Five species of Candida and two species of Cryptococcus, including clinical isolates were screened. Antifungal activity was expressed by minimum inhibitory concentration(MIC). Amphotericin B and fluconazole were used as standard antifungal drugs.Results: Among tested compounds, six substances presented fungal growth inhibition(MIC < 31.2 mg/m L) [three flavone derivatives(1–3), a glycosylated flavonol derivative(5)and two phenolic acids(10 and 12)]. Sorbifolin(1), exhibited potent antifungal activity,demonstrating MIC value of 3.90 mg/m L against Candida glabrata ATCC 90030, Cryptococcus gattii 118 and fluconazole-resistant clinical isolate of Cryptococcus neoformans var. grubii. Pedalin(2) and nitensoside B(3), two glycosylated flavone derivatives, were active against Cryptococcus neoformans ATCC 90012(MIC = 7.80 mg/m L).Conclusions: Flavone derivatives from Pterogyne nitens can serve as prototypes for the design and development of innovative anti-Candida and anti-Cryptococcus hits.展开更多
This work was aimed to study of fungicidal activity and mechanism of action of the killer toxin of Cryptococcus pinus VKM Y-2958. A killer-toxin preparation was obtained and partly purified from the culture liquid of ...This work was aimed to study of fungicidal activity and mechanism of action of the killer toxin of Cryptococcus pinus VKM Y-2958. A killer-toxin preparation was obtained and partly purified from the culture liquid of the yeast Cryptococcus pinus. Its fungicidal activity against the pathogenic yeast Filobasidiella neoformans was assessed by assay of target cells growth inhibition and propidium iodide staining. The preparation contained three peptides with molecular masses of about 11 - 13 kDa, which did not show similarities in the mass spectrometric analysis. When frozen, the killer-toxin preparation remained active for several years. The killer toxin of Cr. pinus exhibits the high fungicidal activity against the known pathogen F. neoformans, is stable during long-term storage, and its mechanism of action is based on damaging target cell membranes. The killer toxin was obtained by a simple procedure and is of interest for the development of novel fungicidal preparations.展开更多
In this study,microcomputer image processing and pattern recognition technology,and the knowledge of morphology and optical characteristics of Cryptococcus neoformans were used for identification of Cryptococcus neofo...In this study,microcomputer image processing and pattern recognition technology,and the knowledge of morphology and optical characteristics of Cryptococcus neoformans were used for identification of Cryptococcus neoformans.Four groups of mice were lethally infected with standard strain,Wuhan strain,American B-2643 strain and Var.Shanghainesis of the Cryptococcus neoformans.The samplescollected included mice brain,lung,kidney,liver,small intestine tissue and were observed under a light microscope.More than 600 images of the fungus were input into a microcomputer.A system of computer for automatic identification of the Cryptoccocus neoformans was developed. The technique involved image preprocessing,imagesegmenting,coding of line-length on the edge,curve fitting,extracting of image feature,building of image library and feature data bank etc..And then,768 images of the clinical samples and other fungus samples whose morphological features tend to be confused with Cryptococcus neoformans were input into microcomputer and subjected to automatic identification.The Cryptococcus neoformans was accurately identified within 15 min,and the consistence rate with results of routine culture was 98%.展开更多
Identification of Cryptococcus neoformans(C neoformans) has been considered depends on the phenotype and biochemical characteristics, especially on its urease positive characteristics During ...Identification of Cryptococcus neoformans(C neoformans) has been considered depends on the phenotype and biochemical characteristics, especially on its urease positive characteristics During the last ten years, there are 4 strains of urease negative C neoformans strains have been discovered, of which 2 were isolated from AIDS patients, 1 from pigeon dropping and another 1 from preserved cultures of 286 strains of C neoformans So far, from medlines, there was none of urease negative strain isolated clinically from non AIDS patient was report Recently, we isolated a strain of urease negative strain of C neoformans from neither AIDS nor immunocompromised patients for the first time展开更多
Objective: To explore more about the immune tolerance and drug resistance of white Cryptococci albidus in AIDS patients with opportunistic Cryptococcus infection. Methods: To analyze drug resistance of the samples of ...Objective: To explore more about the immune tolerance and drug resistance of white Cryptococci albidus in AIDS patients with opportunistic Cryptococcus infection. Methods: To analyze drug resistance of the samples of white Cryptococcus albidus extracted from opportunistic infection AIDS patients in the certain infection area from October 2011 to December 2014. Results: After analyzing two samples of Cryptococcus albidus from 885 cases with opportunistic infection, we found that one of the samples do resist to ten common antibiotics. They were fluconazole, flu-cytosine, fluconazole, caspofungin, amphotericin B, MI miconazole, terbinafine, ketoconazole and itraconazole. The other one was sensitive to voriconazole, but resistant to the rest of the drug. Two strains of bacteria were inoculated into the animals in vivo and their DNA was extracted to carry out the genotyping analysis. The results showed that different degrees of resistance gene amplification bands were found in the 10 kinds of antibiotics. Conclusion: Although there were few opportunistic infection Cryptococcus albidus in AIDS patients, it was easy to show its resistance to drugs. Therefore, great attention should be paid to it for the medical workers.展开更多
Objective: As isolates of Cryptococcus are frequently kept collection stocks in institutions, sometimes without proper characterization, we sought to determine the genotype profiles, protease and phospholipase activit...Objective: As isolates of Cryptococcus are frequently kept collection stocks in institutions, sometimes without proper characterization, we sought to determine the genotype profiles, protease and phospholipase activities “in vitro” and the susceptibility testing for azoles and amphotericin B. Methodology: 84 isolates from several regions of Brazil (40 samples from clinical origin and 44 isolates from environmental origin) were maintained at the microorganism’s bank of the Biomedical Science Institute (ICB-USP) of the São Paulo University, in São Paulo, Brazil. This isolates was submitted fungal strains determination, DNA extraction and purification, determination of genotype by URA5 gene RFLP of CGB-positive isolates, protease and phospholipase activity and susceptibility to antifungals. Results: Of six CGB positive isolates tested by RFLP-PCR, only four presented a genomic profile consistent C. gattii species (VGII), while two other were C. neoformans (VNI and VNIII), indicating the existence of canavanine-resistante C. neoformans isolates in the culture collections. The clinical isolates secreted higher levels of phospholipase and environmental isolates but no differences were observed for the protease levels. Almost all isolates were sensible to azoles and amphotericin B. Conclusion: We point out in this research the existence of C. neoformans strains resistant to canavanine and intrinsic characteristic of C. gatti. These results demonstrate the importance to perform a detailed characterization of isolates kept in culture collections.展开更多
Cryptococcus neoformans is an encapsulated yeast causing mainly opportunistic infections. DNA molecular typing techniques divided C. neoformans into four major molecular types (AFLP1/VNI, AFLP1A/VNB/VNII, AFLP1B/ VNII...Cryptococcus neoformans is an encapsulated yeast causing mainly opportunistic infections. DNA molecular typing techniques divided C. neoformans into four major molecular types (AFLP1/VNI, AFLP1A/VNB/VNII, AFLP1B/ VNII, AFLP3/VNIII, AFLP2/VNIV) characterized by different pathogenicity, geographical distribution and susceptibility to antifungal treatments. In this study 170 Italian C. neoformans clinical isolates (CI) and 32 environmental isolates (EI), collected and serotyped during a ten-year period (1985 to 1995), were genotyped using [GACA]4 microsatellite PCR fingerprinting. The molecular types were compared to their geographic distribution, specimen sources and patient’s risk factors. All four molecular types were described among the CI and only VNI and VNIV among the EI. VNIV molecular type was isolated with significant prevalence among the CI and VNI among the EI. A different geographical distribution of molecular types was detected: VNIV was the most prevalent in the North and Center of Italy;VNIII was isolated almost exclusively in the Center. No significant correlation among molecular types versus predisposing diseases or isolation sources was detected. The strains isolated from different body sites of the same patient (17 cases) were of the same genotype. Five out 9 cases relapsed with a different molecular type. This preliminary investigation shows a high intraspecies variability and reveals a nonhomogeneous distribution of C. neoformans molecular types in Italy.展开更多
A retrospective cross-sectional study for patients with confirmed Cryptococcus neoformans meningitis(CM)in non-HIV-infected and non-transplant hosts in two class-A tertiary hospitals in Guangzhou,China is reported.181...A retrospective cross-sectional study for patients with confirmed Cryptococcus neoformans meningitis(CM)in non-HIV-infected and non-transplant hosts in two class-A tertiary hospitals in Guangzhou,China is reported.181 CM patients were enrolled during the study period,48%(87/181)of which died.Underlying diseases were risk factor associated with higher mortality,among which diabetes mellitus ranked first for the incidence of CM.The mortality was not related to antifungal drug susceptibility.All strains were considered susceptible to amphotericin B,although interpretative breakpoints for amphotericin B have not yet been established.According to the CLSI guidelines,most of the strains in our study were susceptible to voriconazole,fluconazole,fluorocytosine and dose-dependently susceptible to itraconazle.展开更多
BACKGROUND:Meningitis continues to be one of the most important infections diagnosed and treated by emergency physicians.Despite the advent of anti-infective therapy,meningitis carries a mortality rate of 20%-40%.In t...BACKGROUND:Meningitis continues to be one of the most important infections diagnosed and treated by emergency physicians.Despite the advent of anti-infective therapy,meningitis carries a mortality rate of 20%-40%.In this study,we describe the first reported emergency medicine case of meningitis associated with Cryptococcus gattii to alert providers of this insidious,emerging global pathogen infecting immunocompetent individuals.METHODS:We provided a case report and accompanying review of the literature.A MEDLINE search for the term Cryptoccocus gattii was performed to obtain background information on Cryptococcus gattii.RESULTS:After two months of hospitalization,the patient was eventually discharged neurologically intact except for a continued mild bilateral hearing deficit.CONCLUSION:Cryptococcus gattii is an emerging world pathogen,which affects otherwise healthy,immunocompetent patients and requires timely identification and treatment in order to prevent severe neurological sequelae.展开更多
Sarcoidosis is a systemic granulomatosis from an unknown etiology, particularly affecting the lungs and the lymphatic system. It is associated with an immune deficiency involving an excessive immune response mediated ...Sarcoidosis is a systemic granulomatosis from an unknown etiology, particularly affecting the lungs and the lymphatic system. It is associated with an immune deficiency involving an excessive immune response mediated by TH1 lymphocytes. Its evolution can lead to serious complications such as pulmonary fibrosis, pulmonary hypertension, bronchial stenosis and opportunistic infections. Opportunistic infections rarely occur on an underlying sarcoidosis condition. We report a rare case of pulmonary aspergillary and cryptococcal co-infection, on a patient with sarcoidosis who was finally lost to follow up. It was about a 47 years old female patient, diagnosed in 2015 for mediastino-pulmonary and neurological sarcoidosis. She was in therapeutical rupture after a 3-month period of corticotherapy at a dosage of 20 mg daily. The patient has been lost of sight for 3 years and was seen again on November, 22nd, 2018 at the Internal Medicine/Rheumatology Department of DALAL JAMM Hospital. At his admission she presented: a low grade hemoptysia, a chronic cough, a shortness of breath on exertion CRD Stage 2. At the biological investigation, the CRP was at 71.9 mg/l. Calcium serum levels were at 102.6 mg/l. Sputum culture and AFBS were negative. The screening serology of aspergillary Ig G was positive at 12.4 UA/ml. Thoracic High Resonance CT pointed suggests a Stage 2 Sarcoidosis complicated with aspergillary graft. The bronchoscopy showed out a severe suppurated bronchopathy. Microscopic examination of the BAF found some Cryptococcus neoformans settlement. We concluded a diagnosis of pulmonary aspergilloma and cryptococcosis co-infection with an underlying condition of Stage 2 Sarcoidosis. We successfully treated our patient with an oral intake of Itraconazole at a dosage of 400 mg daily over a period of 10 days. This is a rare and life-threatening triple association. In our case, the patient was lost to follow up for a long period and this was considered as the first morbidity risk factor.展开更多
The genus Cryptococcus is composed of encapsulated yeasts that have the ability to infect and cause disease in humans, as Cryptococcus gattii/Cryptococcus neoformans species complex. Facing the current research panel,...The genus Cryptococcus is composed of encapsulated yeasts that have the ability to infect and cause disease in humans, as Cryptococcus gattii/Cryptococcus neoformans species complex. Facing the current research panel, few studies about cryptococcosis and epidemiological data have been carded out in the western region of Sao Paulo state. This study aimed to verify the occurrence of Cryptococcus spp. In public areas of the city of Presidente Prudente, using pigeon droppings and tree hollows as an environmental source. The samples were identified by conventional mycological methods. Were collected 54 samples from pigeon droppings and 62 samples from tree hollows of the genus Licania. And of these samples, 47 (87.0%) and 14 (22.5%) had positive growth of yeast from pigeon droppings and tree hollows, respectively. Cryptococcus was identified in 11 (20.4%) of the samples from pigeon droppings and 3 (21.4%) of those from tree hollows. The following species were identified: Cryptococcus neoformans (7.15%), Cryptococcus laurentti (14.28%), and Cryptococcus albidus (78.57%). Decreased susceptibility to fluconazole was observed for some isolates. Fluconazole exhibited a limited in vitro activity, particularly against Cryptococcus albidus and Cryptococcus laurentii. Identification and susceptibility testing of Cryptococcus spp. should be performed on a routine basis in view of their unpredictable susceptibility profiles.展开更多
Background Emerging fungal pathogens pose important threats to global public health. The World Health Organization has responded to the rising threat of traditionally neglected fungal infections by developing a Fungal...Background Emerging fungal pathogens pose important threats to global public health. The World Health Organization has responded to the rising threat of traditionally neglected fungal infections by developing a Fungal Priority Pathogens List (FPPL). Taking the highest-ranked fungal pathogen in the FPPL,Cryptococcus neoformans, as a paradigm, we review progress made over the past two decades on its global burden, its clinical manifestation and management of cryptococcal infection, and its antifungal resistance. The purpose of this review is to drive research efforts to improve future diagnoses, therapies, and interventions associated with fungal infections.Methods We first reviewed trends in the global burden of HIV-associated cryptococcal infection, mainly based on a series of systematic studies. We next conducted scoping reviews in accordance with the guidelines described in the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews using PubMed and ScienceDirect with the keywordCryptococcus neoformans to identify case reports of cryptococcal infections published since 2000. We then reviewed recent updates on the diagnosis and antifungal treatment of cryptococcal infections. Finally, we summarized knowledge regarding the resistance and tolerance ofC. neoformans to approved antifungal drugs.Results There has been a general reduction in the estimated global burden of HIV-associated cryptococcal meningitis since 2009, probably due to improvements in highly active antiretroviral therapies. However, cryptococcal meningitis still accounts for 19% of AIDS-related deaths annually. The incidences of CM in Europe and North America and the Latin America region have increased by approximately two-fold since 2009, while other regions showed either reduced or stable numbers of cases. Unfortunately, diagnostic and treatment options for cryptococcal infections are limited, and emerging antifungal resistance exacerbates the public health burden.Conclusions The rising threat ofC. neoformans is compounded by accumulating evidence for its ability to infect immunocompetent individuals and the emergence of antifungal-resistant variants. Emphasis should be placed on further understanding the mechanisms of pathogenicity and of antifungal resistance and tolerance. The development of novel management strategies through the identification of new drug targets and the discovery and optimization of new and existing diagnostics and therapeutics are key to reducing the health burden.展开更多
Background Despite recent reports on the molecular epidemiology of cryptococcal infections in China,clinical isolates have been mostly reported from human immunodeficiency virus (HIV)-negative patients,and environme...Background Despite recent reports on the molecular epidemiology of cryptococcal infections in China,clinical isolates have been mostly reported from human immunodeficiency virus (HIV)-negative patients,and environmental isolates from China have rarely been included.The aim of this study was to investigate the ecological profile of Cryptococcus (C.)neoformans and C.gattii in China.Methods A survey was performed in 10 cities from 20°N (North latitude) to 50°N and in a Eucalyptus (E.) camaldulensis forestry farm at the Guixi forestry center,China.Results Six hundred and twenty samples of pigeon droppings from 10 cities and 819 E.camaldulensis tree samples were collected and inoculated on caffeic acid cornmeal agar (CACA).The brown-colored colonies were recultured to observe their morphology,growth on canavanine-glycine-bromothymol-blue (CGB) medium,phenol oxidase and urease activities,serotype and mating type.There were obvious differences in the positive sample rates of C.neoformans in pigeon droppings collected from the different cities,ranging from 50% in the cities located at latitudes from 30°N-40°N,29% at 20°N-30°N and 13% at 40°N-50°N.Conclusions There were no differences in positive bevy rates (approximately 80%) among the three grouped cities.Mycological tests of 101 isolates purified from pigeon droppings revealed that they were C.neoformans var.grubii.We also observed variable capsular size around the C.neoformans cells in colonies with variable melanin production and the bio-adhesion of the natural C.neoformans cells with other microorganisms.One urease-negative C.neoformans isolatewas isolated from pigeon droppings in Jinan city.No C.gattiiwas isolated in this study.展开更多
文摘In this paper, the crawler, second instar female and male, prepupa, pupa and adult male of Cryptococcus ulmi are described and illustrated for the first time; adult female is redescribed; a key to all stages is given and the biology is briefly repor ted.
基金Campbell TG received support from the Hector Maclean Scholarship through the Centre for Eye Research Australia and Department of Surgery,University of Melbourne,Australia。
文摘AIM:To report 4 cases of Cryptococcus gattii(C.gattii)species complex infection with diverse ophthalmic manifestations,and to review the literature to examine pathobiology of disease,classical ophthalmic presentations and outcomes,and treatment modalities for this emerging pathogen.METHODS:Cases of C.gattii meningoencephalitis with ophthalmic manifestations were identified via chart review at two institutions in Australia and one institution in the mid-west region of the United States and are reported as a case series.Additionally,a MEDLINE literature review was conducted to identify all reported cases of C.gattii with ophthalmic manifestations from 1990-2020.Cases were reviewed and tabulated,together with our series of patients,in this report.RESULTS:Four cases of C.gattii with ophthalmic manifestations are presented;three from Australia and one from the USA.A literature review identified a total of 331 cases of C.gattii with visual sequelae.The majority of cases occurred in immunocompetent individuals.Blurred vision and diplopia were the most common presenting symptoms,with papilloedema the most common sign,reported in 10%-50%of cases.Visual loss was reported in 10%-53%of cases,as compared to rates of visual loss of 1%-9%in C.neoformans infection.Elevated intracranial pressure,cerebrospinal fluid(CSF)fungal burden,and abnormal neurological exam at presentation correlated with poor visual outcomes.The mainstays of treatment are anti-fungal agents and aggressive management of intracranial hypertension with serial lumbar punctures.CSF diversion procedures should be considered for refractory cases.Acetazolamide and mannitol are associated with high complication rates,and adjuvant corticosteroids have demonstrated higher mortality rates;these treatments should be avoided.CONCLUSION:Permanent visual loss represents a devastating yet potentially preventable sequelae of C.gattii infection.Intracranial hypertension needs to be recognised early and aggressively managed.Referral to an ophthalmologist/neuro-ophthalmologist in all cases of cryptococcal infection independent of visual symptoms at time of diagnosis is recommended.
文摘Background: Yeasts from the genus Cryptococcus (species C. neoformans and C. gattii) are opportunistic pathogens that afflict humans with low immunity caused by diseases such as AIDS or by the usage of immunosuppressive drugs. It is a fatal disease that has been studied around the whole world and its most fatal form is the brain cryptococcosis. Purpose: The present review describes the disease from pathogen isolation, the various clinical presentations of the disease, the most important virulence factors of yeast in human and animal model and their clinical issues. Methods: On this review, several published studies about the disease are presented. Results: Numerous researches have been done worldwide in order to find a kind of therapy that is more effective against the disease. Amphotericin B, in all forms is still the drug of choice in the treatment of the cryptococcosis. Fluconazole, as well as voriconazole in combination with amphotericin B, is recommended in the cases of treatment failure. Conclusion: This study presented has elucidated a little more about the disease. Further studies should be conducted to find more diagnoses that are accurate as well as more effective treatments for eradicating the disease. In this study, the bibliographic survey makes reference to the world literature;with regard to ecology, taxonomy, mains factors related to virulence, the clinical manifestations, the action of antifungal drugs and histopathological analysis used in an animal model, were the objectives deleterious aspects of this study, thus informing, in a simple way, the importance of this microorganism for research and researchers working with this global disease, called Cryptococcosis.
基金the Knowledge Innovation Program of the Chinese Academy of Sciences, China (KSCX2-YW-G-010); the National Natural Science Foundation of China (30671473).
文摘The present study was performed mainly to investigate the antagonist-pathogen-host interaction in wounds of the sweet cherry fruits. The antagonistic yeast Cryptococcus laurentii could significantly reduce the brown rot of the sweet cherry fruit caused by Monilinia fructicola at 25 and 1 ℃. The populations of yeast increased faster in the presence of the pathogen initially, but then decreased rapidly. In the fruits inoculated with M. fructicola alone or combined with C. laurentii, an induction of lipid peroxidation as well as activities of the antioxidant enzymes, such as, superoxide dismutases (SOD), catalase (CAT), and peroxidase (POD), was observed. The isoenzyme pattern of polypheno/oxidase (PPO) changed greatly after the symptoms appeared, with new PPO isoforms being induced. By contrast, the induction of lipid peroxidation and activities of SOD, CAT, and POD were low, although no significant changes were found in the PPO isoenzyms in the fruits inoculated with antagonist C. laurentii alone. The inhibition of brown rot during the antagonist- pathogen-host interaction in wounds of the sweet cherry fruits was mainly on account of the stimulated growth of C. laurentii as well as the induction of antioxidant enzymes of the fruits by M. fructicola.
基金The Colleges and Universities in Anhui Province Natural Science Research Projects,No.KJ2018A0208.
文摘BACKGROUND Cryptococcus presenting as an opportunistic pathogen mainly affects immunocompromised patients,but the disseminated form of infection is rare among immunocompetent populations.The partial radiographic characteristics of pulmonary cryptococcosis mimic lung carcinoma,leading to unnecessary open chest exploratory surgery,and the lack of a gold-standard noninvasive diagnostic increases the risk of misdiagnosis.Positron emission tomography/computed tomography(PET/CT),a sensitive method for distinguishing malignant tumors,coupled with cryptococcal latex agglutination test showing a high positive rate may overcome these issues.CASE A 36-year-old man presented for general examination,without health complaints.Routine CT showed multiple pulmonary nodules and a mass with high maximum standardized uptake value.Initially,we suspected primary malignancy with hematogenous metastasis.Although his routine fungal analysis had been negative,subsequent CT-guided percutaneous core needle biopsy and histopathology examination indicated a diagnosis of pulmonary cryptococcosis.Fluconazole(200 mg/d)antifungal drug treatment was initiated,and 1 mo later the pulmonary mass had reduced in size markedly(on chest CT scan)without any complications.CONCLUSION Serologic and PET/CT examinations may not rule out cryptococcosis,and percutaneous lung puncture is critical under all circumstances.
基金Supported by the"Scientific Research Fund for Neglected Tropical Diseases"(Project Grant number J500798759)the Argentinian Institutes for Health System Improvement-a Public Health Agency.through a scholarship(Grant numbers300820891)
文摘We communicate the diagnosis by microscopy of a pulmonary coinfection produced by Cryptococcus neoformans and Pneumocystis jiroveci,from a respiratory secretion obtained by bronchoalveolar lavage of an AIDS patient.Our review of literature identified this coinfection as unusual presentation.Opportunistic infections associated with HIV infection are increasingly recognized.It may occur at an early stage of HIV-infection.Whereas concurrent opportunistic infections may occur,coexisting Pneumocystis jiroveci pneumonia(PCP)and disseminated cryptococcosis with cryptococcal pneumonia is uncommon.The lungs of individuals infected with HIV are often affected by opportunistic infections and tumours and over two-thirds of patients have at least one respiratory episode during the course of their disease.Pneumonia is the leading HIV-associated infection.We present the case of a man who presented dual Pneumocystis jiroveci and cryptococcal pneumonia in a patient with HIV.Definitive diagnosis of PCP and Cryptococcus requires demonstration of these organisms in pulmonary tissues or fluid.In patients with<200/microliter CD4-lymphocytes,a bronchoalveolar lavage should be performed.This patient was successfully treated with amphotericin B and trimethoprim sulfamethoxazole.After 1 week the patient showed clinical and radiologic improvement and was discharged 3 weeks later.
基金Supported by Support Foundation of Sao Paulo Research(FAPESP,Grant No.2014/05445-3)National Council of Technological and Scientific Development(CNPq)Office of Research of the Sao Paulo State University
文摘Objective: To evaluate anti-Candida and anti-Cryptococcus activities of 15 nonalkaloidal compounds from Pterogyne nitens Tulasne(Leguminosae), a South American medicinal plant.Methods: Compounds were submitted to antifungal assays, using microdilution method described by Clinical and Laboratory Standards Institute document, with minor modifications. Five species of Candida and two species of Cryptococcus, including clinical isolates were screened. Antifungal activity was expressed by minimum inhibitory concentration(MIC). Amphotericin B and fluconazole were used as standard antifungal drugs.Results: Among tested compounds, six substances presented fungal growth inhibition(MIC < 31.2 mg/m L) [three flavone derivatives(1–3), a glycosylated flavonol derivative(5)and two phenolic acids(10 and 12)]. Sorbifolin(1), exhibited potent antifungal activity,demonstrating MIC value of 3.90 mg/m L against Candida glabrata ATCC 90030, Cryptococcus gattii 118 and fluconazole-resistant clinical isolate of Cryptococcus neoformans var. grubii. Pedalin(2) and nitensoside B(3), two glycosylated flavone derivatives, were active against Cryptococcus neoformans ATCC 90012(MIC = 7.80 mg/m L).Conclusions: Flavone derivatives from Pterogyne nitens can serve as prototypes for the design and development of innovative anti-Candida and anti-Cryptococcus hits.
文摘This work was aimed to study of fungicidal activity and mechanism of action of the killer toxin of Cryptococcus pinus VKM Y-2958. A killer-toxin preparation was obtained and partly purified from the culture liquid of the yeast Cryptococcus pinus. Its fungicidal activity against the pathogenic yeast Filobasidiella neoformans was assessed by assay of target cells growth inhibition and propidium iodide staining. The preparation contained three peptides with molecular masses of about 11 - 13 kDa, which did not show similarities in the mass spectrometric analysis. When frozen, the killer-toxin preparation remained active for several years. The killer toxin of Cr. pinus exhibits the high fungicidal activity against the known pathogen F. neoformans, is stable during long-term storage, and its mechanism of action is based on damaging target cell membranes. The killer toxin was obtained by a simple procedure and is of interest for the development of novel fungicidal preparations.
文摘In this study,microcomputer image processing and pattern recognition technology,and the knowledge of morphology and optical characteristics of Cryptococcus neoformans were used for identification of Cryptococcus neoformans.Four groups of mice were lethally infected with standard strain,Wuhan strain,American B-2643 strain and Var.Shanghainesis of the Cryptococcus neoformans.The samplescollected included mice brain,lung,kidney,liver,small intestine tissue and were observed under a light microscope.More than 600 images of the fungus were input into a microcomputer.A system of computer for automatic identification of the Cryptoccocus neoformans was developed. The technique involved image preprocessing,imagesegmenting,coding of line-length on the edge,curve fitting,extracting of image feature,building of image library and feature data bank etc..And then,768 images of the clinical samples and other fungus samples whose morphological features tend to be confused with Cryptococcus neoformans were input into microcomputer and subjected to automatic identification.The Cryptococcus neoformans was accurately identified within 15 min,and the consistence rate with results of routine culture was 98%.
文摘Identification of Cryptococcus neoformans(C neoformans) has been considered depends on the phenotype and biochemical characteristics, especially on its urease positive characteristics During the last ten years, there are 4 strains of urease negative C neoformans strains have been discovered, of which 2 were isolated from AIDS patients, 1 from pigeon dropping and another 1 from preserved cultures of 286 strains of C neoformans So far, from medlines, there was none of urease negative strain isolated clinically from non AIDS patient was report Recently, we isolated a strain of urease negative strain of C neoformans from neither AIDS nor immunocompromised patients for the first time
文摘Objective: To explore more about the immune tolerance and drug resistance of white Cryptococci albidus in AIDS patients with opportunistic Cryptococcus infection. Methods: To analyze drug resistance of the samples of white Cryptococcus albidus extracted from opportunistic infection AIDS patients in the certain infection area from October 2011 to December 2014. Results: After analyzing two samples of Cryptococcus albidus from 885 cases with opportunistic infection, we found that one of the samples do resist to ten common antibiotics. They were fluconazole, flu-cytosine, fluconazole, caspofungin, amphotericin B, MI miconazole, terbinafine, ketoconazole and itraconazole. The other one was sensitive to voriconazole, but resistant to the rest of the drug. Two strains of bacteria were inoculated into the animals in vivo and their DNA was extracted to carry out the genotyping analysis. The results showed that different degrees of resistance gene amplification bands were found in the 10 kinds of antibiotics. Conclusion: Although there were few opportunistic infection Cryptococcus albidus in AIDS patients, it was easy to show its resistance to drugs. Therefore, great attention should be paid to it for the medical workers.
文摘Objective: As isolates of Cryptococcus are frequently kept collection stocks in institutions, sometimes without proper characterization, we sought to determine the genotype profiles, protease and phospholipase activities “in vitro” and the susceptibility testing for azoles and amphotericin B. Methodology: 84 isolates from several regions of Brazil (40 samples from clinical origin and 44 isolates from environmental origin) were maintained at the microorganism’s bank of the Biomedical Science Institute (ICB-USP) of the São Paulo University, in São Paulo, Brazil. This isolates was submitted fungal strains determination, DNA extraction and purification, determination of genotype by URA5 gene RFLP of CGB-positive isolates, protease and phospholipase activity and susceptibility to antifungals. Results: Of six CGB positive isolates tested by RFLP-PCR, only four presented a genomic profile consistent C. gattii species (VGII), while two other were C. neoformans (VNI and VNIII), indicating the existence of canavanine-resistante C. neoformans isolates in the culture collections. The clinical isolates secreted higher levels of phospholipase and environmental isolates but no differences were observed for the protease levels. Almost all isolates were sensible to azoles and amphotericin B. Conclusion: We point out in this research the existence of C. neoformans strains resistant to canavanine and intrinsic characteristic of C. gatti. These results demonstrate the importance to perform a detailed characterization of isolates kept in culture collections.
文摘Cryptococcus neoformans is an encapsulated yeast causing mainly opportunistic infections. DNA molecular typing techniques divided C. neoformans into four major molecular types (AFLP1/VNI, AFLP1A/VNB/VNII, AFLP1B/ VNII, AFLP3/VNIII, AFLP2/VNIV) characterized by different pathogenicity, geographical distribution and susceptibility to antifungal treatments. In this study 170 Italian C. neoformans clinical isolates (CI) and 32 environmental isolates (EI), collected and serotyped during a ten-year period (1985 to 1995), were genotyped using [GACA]4 microsatellite PCR fingerprinting. The molecular types were compared to their geographic distribution, specimen sources and patient’s risk factors. All four molecular types were described among the CI and only VNI and VNIV among the EI. VNIV molecular type was isolated with significant prevalence among the CI and VNI among the EI. A different geographical distribution of molecular types was detected: VNIV was the most prevalent in the North and Center of Italy;VNIII was isolated almost exclusively in the Center. No significant correlation among molecular types versus predisposing diseases or isolation sources was detected. The strains isolated from different body sites of the same patient (17 cases) were of the same genotype. Five out 9 cases relapsed with a different molecular type. This preliminary investigation shows a high intraspecies variability and reveals a nonhomogeneous distribution of C. neoformans molecular types in Italy.
文摘A retrospective cross-sectional study for patients with confirmed Cryptococcus neoformans meningitis(CM)in non-HIV-infected and non-transplant hosts in two class-A tertiary hospitals in Guangzhou,China is reported.181 CM patients were enrolled during the study period,48%(87/181)of which died.Underlying diseases were risk factor associated with higher mortality,among which diabetes mellitus ranked first for the incidence of CM.The mortality was not related to antifungal drug susceptibility.All strains were considered susceptible to amphotericin B,although interpretative breakpoints for amphotericin B have not yet been established.According to the CLSI guidelines,most of the strains in our study were susceptible to voriconazole,fluconazole,fluorocytosine and dose-dependently susceptible to itraconazle.
文摘BACKGROUND:Meningitis continues to be one of the most important infections diagnosed and treated by emergency physicians.Despite the advent of anti-infective therapy,meningitis carries a mortality rate of 20%-40%.In this study,we describe the first reported emergency medicine case of meningitis associated with Cryptococcus gattii to alert providers of this insidious,emerging global pathogen infecting immunocompetent individuals.METHODS:We provided a case report and accompanying review of the literature.A MEDLINE search for the term Cryptoccocus gattii was performed to obtain background information on Cryptococcus gattii.RESULTS:After two months of hospitalization,the patient was eventually discharged neurologically intact except for a continued mild bilateral hearing deficit.CONCLUSION:Cryptococcus gattii is an emerging world pathogen,which affects otherwise healthy,immunocompetent patients and requires timely identification and treatment in order to prevent severe neurological sequelae.
文摘Sarcoidosis is a systemic granulomatosis from an unknown etiology, particularly affecting the lungs and the lymphatic system. It is associated with an immune deficiency involving an excessive immune response mediated by TH1 lymphocytes. Its evolution can lead to serious complications such as pulmonary fibrosis, pulmonary hypertension, bronchial stenosis and opportunistic infections. Opportunistic infections rarely occur on an underlying sarcoidosis condition. We report a rare case of pulmonary aspergillary and cryptococcal co-infection, on a patient with sarcoidosis who was finally lost to follow up. It was about a 47 years old female patient, diagnosed in 2015 for mediastino-pulmonary and neurological sarcoidosis. She was in therapeutical rupture after a 3-month period of corticotherapy at a dosage of 20 mg daily. The patient has been lost of sight for 3 years and was seen again on November, 22nd, 2018 at the Internal Medicine/Rheumatology Department of DALAL JAMM Hospital. At his admission she presented: a low grade hemoptysia, a chronic cough, a shortness of breath on exertion CRD Stage 2. At the biological investigation, the CRP was at 71.9 mg/l. Calcium serum levels were at 102.6 mg/l. Sputum culture and AFBS were negative. The screening serology of aspergillary Ig G was positive at 12.4 UA/ml. Thoracic High Resonance CT pointed suggests a Stage 2 Sarcoidosis complicated with aspergillary graft. The bronchoscopy showed out a severe suppurated bronchopathy. Microscopic examination of the BAF found some Cryptococcus neoformans settlement. We concluded a diagnosis of pulmonary aspergilloma and cryptococcosis co-infection with an underlying condition of Stage 2 Sarcoidosis. We successfully treated our patient with an oral intake of Itraconazole at a dosage of 400 mg daily over a period of 10 days. This is a rare and life-threatening triple association. In our case, the patient was lost to follow up for a long period and this was considered as the first morbidity risk factor.
文摘The genus Cryptococcus is composed of encapsulated yeasts that have the ability to infect and cause disease in humans, as Cryptococcus gattii/Cryptococcus neoformans species complex. Facing the current research panel, few studies about cryptococcosis and epidemiological data have been carded out in the western region of Sao Paulo state. This study aimed to verify the occurrence of Cryptococcus spp. In public areas of the city of Presidente Prudente, using pigeon droppings and tree hollows as an environmental source. The samples were identified by conventional mycological methods. Were collected 54 samples from pigeon droppings and 62 samples from tree hollows of the genus Licania. And of these samples, 47 (87.0%) and 14 (22.5%) had positive growth of yeast from pigeon droppings and tree hollows, respectively. Cryptococcus was identified in 11 (20.4%) of the samples from pigeon droppings and 3 (21.4%) of those from tree hollows. The following species were identified: Cryptococcus neoformans (7.15%), Cryptococcus laurentti (14.28%), and Cryptococcus albidus (78.57%). Decreased susceptibility to fluconazole was observed for some isolates. Fluconazole exhibited a limited in vitro activity, particularly against Cryptococcus albidus and Cryptococcus laurentii. Identification and susceptibility testing of Cryptococcus spp. should be performed on a routine basis in view of their unpredictable susceptibility profiles.
基金supported by the National Key Research and Development Program of China[2022YFC2303000(L.W.),2021YFC2300400(L.W.)]the CAS Interdisciplinary Innovation Team(L.W.),and Henan Agricultural University[30900880(Y.Z.),30500946(Y.Z.)].
文摘Background Emerging fungal pathogens pose important threats to global public health. The World Health Organization has responded to the rising threat of traditionally neglected fungal infections by developing a Fungal Priority Pathogens List (FPPL). Taking the highest-ranked fungal pathogen in the FPPL,Cryptococcus neoformans, as a paradigm, we review progress made over the past two decades on its global burden, its clinical manifestation and management of cryptococcal infection, and its antifungal resistance. The purpose of this review is to drive research efforts to improve future diagnoses, therapies, and interventions associated with fungal infections.Methods We first reviewed trends in the global burden of HIV-associated cryptococcal infection, mainly based on a series of systematic studies. We next conducted scoping reviews in accordance with the guidelines described in the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews using PubMed and ScienceDirect with the keywordCryptococcus neoformans to identify case reports of cryptococcal infections published since 2000. We then reviewed recent updates on the diagnosis and antifungal treatment of cryptococcal infections. Finally, we summarized knowledge regarding the resistance and tolerance ofC. neoformans to approved antifungal drugs.Results There has been a general reduction in the estimated global burden of HIV-associated cryptococcal meningitis since 2009, probably due to improvements in highly active antiretroviral therapies. However, cryptococcal meningitis still accounts for 19% of AIDS-related deaths annually. The incidences of CM in Europe and North America and the Latin America region have increased by approximately two-fold since 2009, while other regions showed either reduced or stable numbers of cases. Unfortunately, diagnostic and treatment options for cryptococcal infections are limited, and emerging antifungal resistance exacerbates the public health burden.Conclusions The rising threat ofC. neoformans is compounded by accumulating evidence for its ability to infect immunocompetent individuals and the emergence of antifungal-resistant variants. Emphasis should be placed on further understanding the mechanisms of pathogenicity and of antifungal resistance and tolerance. The development of novel management strategies through the identification of new drug targets and the discovery and optimization of new and existing diagnostics and therapeutics are key to reducing the health burden.
基金This study was supported by grants from the National Natural Science Foundation of China (No.80171335,No.30970130),the PLA Clinical High-tech Major Projects Fund (No.2010gxjs063),and Shanghai Science and Technology Commission Fund (No.10dz2220100).
文摘Background Despite recent reports on the molecular epidemiology of cryptococcal infections in China,clinical isolates have been mostly reported from human immunodeficiency virus (HIV)-negative patients,and environmental isolates from China have rarely been included.The aim of this study was to investigate the ecological profile of Cryptococcus (C.)neoformans and C.gattii in China.Methods A survey was performed in 10 cities from 20°N (North latitude) to 50°N and in a Eucalyptus (E.) camaldulensis forestry farm at the Guixi forestry center,China.Results Six hundred and twenty samples of pigeon droppings from 10 cities and 819 E.camaldulensis tree samples were collected and inoculated on caffeic acid cornmeal agar (CACA).The brown-colored colonies were recultured to observe their morphology,growth on canavanine-glycine-bromothymol-blue (CGB) medium,phenol oxidase and urease activities,serotype and mating type.There were obvious differences in the positive sample rates of C.neoformans in pigeon droppings collected from the different cities,ranging from 50% in the cities located at latitudes from 30°N-40°N,29% at 20°N-30°N and 13% at 40°N-50°N.Conclusions There were no differences in positive bevy rates (approximately 80%) among the three grouped cities.Mycological tests of 101 isolates purified from pigeon droppings revealed that they were C.neoformans var.grubii.We also observed variable capsular size around the C.neoformans cells in colonies with variable melanin production and the bio-adhesion of the natural C.neoformans cells with other microorganisms.One urease-negative C.neoformans isolatewas isolated from pigeon droppings in Jinan city.No C.gattiiwas isolated in this study.