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Финголимод, связанный с криптококковым менингитом у пациента с множественным склерозом: доклад о деле и обзор литературы.

У 65-летней женщины с множественным склерозом появились головные боли и судороги. Культура цереброспиновой жидкости (CSF) указывает на неоформаны криптококка. Анализ литературы по 20 случаям криптококкового менингита показал, что головная боль является наиболее распространенным первоначальным симптомом, и все случаи были положительными для сыворотки и/или криптококковых антигенов CSF.

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… The mortality rate was 16 % (3/19), which was the similar to or lower than in the previous studies on cryptococcosis-related mortality in various populations [29] . Fingolimod-associated cryptococcal meningitis is a rare but potentially lethal infection if the diagnosis is delayed. …

A 64-year-old woman with rapid neurologic decline diagnosed with Toxoplasma encephalitis after presumed metastatic cancer.

In an era of fragmented medical care, concurrent clinical features that ultimately lead to a unified diagnosis may not be prioritized appropriately. We present a case of a 64-year-old woman referred to hematology clinic for anemia, with recent memory loss and gait disturbance. Two months later, she developed pneumonia; imaging workup showed a left renal mass. Neurologic function continued to decline precluding definitive nephrectomy. She then presented with new-onset seizure and initial neuro-imaging was reported as unremarkable. One month later, outpatient neurologic workup demonstrated new l

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… Differential diagnosis for a ring-enhancing brain lesion (adapted from Garg 11 ) Bacterial Listeriosis Mycobacterium avium–intracellulare Pyogenic abscess Tuberculoma and tuberculous abscess Fungal Aspergillosis Cryptococcosis Rhodococcosis Zygomycosis Histoplasmosis Coccidioidomycosis Nocardiosis Mucormycosis …

Infections associated with immunotherapeutic and molecular targeted agents in hematology and oncology. A position paper by the European Conference on Infections in Leukemia (ECIL).

A multitude of new agents for the treatment of hematologic malignancies has been introduced over the past decade. Hematologists, infectious disease specialists, stem cell transplant experts, pulmonologists and radiologists have met within the framework of the European Conference on Infections in Leukemia (ECIL) to provide a critical state-of-the-art on infectious complications associated with immunotherapeutic and molecular targeted agents used in clinical routine. For brentuximab vedotin, blinatumomab, CTLA4- and PD-1/PD-L1-inhibitors as well as for ibrutinib, idelalisib, HDAC inhibitors, mTO

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… During a 5-year period (2012−2016), invasive fungal infection (including pulmonary and disseminated aspergillosis, pulmonary cryptococcosis, and PcP) developed in 4.2% of ibrutinib-treated patients at the Memorial Sloan Kettering Cancer Center [ 103 ]. … Disseminated cryptococcosis with brain involvement in patients with chronic lymphoid malignancies on ibrutinib. Open Forum Infect Dis. 2017;4:ofw261. 89. Okamoto Koh, Proia Laurie A., Demarais Patricia L. …

Bloodstream infections in liver transplant recipients receiving tacrolimus.

The microbial origin, timing, risk factors, and outcome of bloodstream infections (bacteremia and fungemia) were prospectively analyzed in 130 consecutive liver transplant recipients receiving tacrolimus-based immunosuppression; median followup was 3 yr. 22% (29/130) of the patients developed 36 episodes of bloodstream infections (0.28 episodes/patient). Bloodstream infections accounted for 36% (36/100) of all major infections. 81% (29/36) of bloodstream infections were due to bacteremia and 19% (7/36) due to fungemia (candidemia 14% and cryptococcemia 5%). Intravascular catheters were the mos

Cyclic AMP-dependent protein kinase catalytic subunits have divergent roles in virulence factor production in two varieties of the fungal pathogen Cryptococcus neoformans.

Our earlier findings established that cyclic AMP-dependent protein kinase functions in a signaling cascade that regulates mating and virulence of Cryptococcus neoformans var. grubii (serotype A). Mutants lacking the serotype A protein kinase A (PKA) catalytic subunit Pka1 are unable to mate, fail to produce melanin or capsule, and are avirulent in animal models, whereas mutants lacking the PKA regulatory subunit Pkr1 overproduce capsule and are hypervirulent. Because other mutations have been observed to confer different phenotypes in two diverged varieties of C. neoformans (grubii variety [se

Guidelines for preventing opportunistic infections among HIV-infected persons--2002. Recommendations of the U.S. Public Health Service and the Infectious Diseases Society of America.

In 1995, the U.S. Public Health Service (USPHS) and the Infectious Diseases Society of America (IDSA) developed guidelines for preventing opportunistic infections (OIs) among persons infected with human immunodeficiency virus (HIV); these guidelines were updated in 1997 and 1999. This fourth edition of the guidelines, made available on the Internet in 2001, is intended for clinicians and other health-care providers who care for HIV-infected persons. The goal of these guidelines is to provide evidence-based guidelines for preventing OIs among HIV-infected adults and adolescents, including pregn

Neurological manifestations of the acquired immunodeficiency syndrome (AIDS): experience at UCSF and review of the literature.

In this review of the acquired immunodeficiency syndrome (AIDS), the authors have evaluated a total of 352 homosexual patients with AIDS or generalized lymphadenopathy managed at the University of California, San Francisco (UCSF), between 1979 and 1984. Of an initial unselected group of 318 patients, 124 (39%) were neurologically symptomatic, and one-third already had their neurological complaints at the time of presentation. An additional 210 AIDS patients with neurological symptoms have been reported in the literature. Thus, a total of 366 neurologically symptomatic patients with AIDS or lym

Preventing osteolytic lesions and osteomyelitis in multiple myeloma.

Multiple myeloma is a hematological malignancy affecting the plasma cells. It is the second most common hematologic cancer in adults. Over 90% of patients develop local osteolytic lesions and skeletal-related events at some point during the progression of the disease. Bone lesions can induce severe pain and immobility and can also increase the risk of fractures and osteomyelitis. Skeletal complications are associated with poor clinical outcomes, affecting quality of life and mortality. Current standards of care for myeloma, e.g., autologous stem-cell transplantation (ASCT) and chemotherapy, do

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… Bone histology was consistent with cryptococcosis. Serum positive for cryptococcal antigen. Received intravenous liposomal amphotericin B (5 mg/kg daily) for one week and was discharged on a high dose (800 mg/d) of oral fluconazole. … Tissue cultures and bone histology later identified Cryptococcosis. The patient had then received intravenous liposomal amphotericin B (5 mg/kg daily) for one week and was discharged on a high dose (800 mg/day) of oral fluconazole. …

Fungal, Viral, and Other Oddball Infections and the Immunosuppressed Patient

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… Some of these infections include cryptococcosis, blastomycosis, histoplasmosis, and coccidioidosis. Often, diagnosis is delayed because symptoms tend to be atypical in most patients. …

Guidelines for preventing opportunistic infections among HIV-infected persons--2002. Recommendations of the U.S. Public Health Service and the Infectious Diseases Society of America.

In 1995, the U.S. Public Health Service (USPHS) and the Infectious Diseases Society of America (IDSA) developed guidelines for preventing opportunistic infections (OIs) among persons infected with human immunodeficiency virus (HIV); these guidelines were updated in 1997 and 1999. This fourth edition of the guidelines, made available on the Internet in 2001, is intended for clinicians and other health-care providers who care for HIV-infected persons. The goal of these guidelines is to provide evidence-based guidelines for preventing OIs among HIV-infected adults and adolescents, including pregn

The mouse antibody response to infection with Cryptococcus neoformans: VH and VL usage in polysaccharide binding antibodies.

Cryptococcus neoformans is a ubiquitous fungus that can cause serious infections in humans. The fungus has a polysaccharide (C. neoformans capsular polysaccharide; CNPS) capsule that contributes to its pathogenicity and can elicit an antibody response. Nevertheless, only 4 of 60 BALB/c mice chronically infected with C. neoformans had a detectable increase in serum anti-CNPS. The sera of three responder mice contained both IgM and IgG anti-CNPS antibody, and the titers of lambda and kappa anti-CNPS antibody were approximately equal. Eight IgM and one IgG3 monoclonal antibodies (mAbs) were gener

9th Trends in Medical Mycology Held on 11-14 October 2019, Nice, France, Organized under the Auspices of EORTC-IDG and ECMM.

Dear Friends and Colleagues,It is a great honor and pleasure for us to invite you cordially to participate in the 9th Congress on Trends in Medical Mycology (TIMM-9) [...].

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… Discussion Symposium 4 | | MSG Symposium (Trial Design in Clinical Mycology: Innovative Approaches) | | Chairs: Peter Pappas, USA & Sharon Chen, FECMM, Australia 13:45 | S04.1 | Candidiasis | | Bart-Jan Kullberg, The Netherlands 14:05 | S04.2 | Endemic Mycoses | | George Thompson, USA 14:25 | S04.3 | Cryptococcosis …

[Clinical practice guidelines for the diagnosis and management of invasive pulmonary fungal diseases (2025 Edition)].

To further standardize the diagnosis and treatment of invasive pulmonary fungal disease (IPFD) in China, particularly in non-immunosuppresse … evidence level: 4).Recommendation 8: Lumbar puncture should be performed in patients with pulmonary cryptococcosis and neurological symptoms, high serum CrAg titres, or immunocompromised status (evidence level: 3).Recommendation 9: For patients with fluconazole resistance or treatment failure, the following: 1) Severe infection: induction therapy with L-AmB (3-6 …

The clinical features, treatment and prognosis of neutropenic fever and Coronavirus disease 2019 results of the multicentre teos study.

This multicentre (22 centres in Turkey) retrospective cohort study aimed to assess the clinical outcomes of patients with neutropenic fever and SARS-CoV-2 positivity. Study period was 15 March 2020-15 August 2021. A total of 170 cases (58 female, aged 59 ± 15.5 years) that fulfilled the inclusion criteria were included in the study. One-month mortality rate (OMM) was 44.8%. The logistic regression analysis showed the following significant variables for the mentioned dependent variables: (i) achieving PCR negativity: receiving a maximum of 5 days of favipiravir (p = 0.005, OR 5.166, 95% CI 1.63

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… Studies have also reported co-infections with candidiasis, mucormycosis, and cryptococcosis in COVID-19 patients 34 . In our study, 23.5% (40/170) of the overall cohort had a fungal co-infection. … We did not identify any cases of mucormycosis or cryptococcosis in our cohort. This might be due to the relatively limited number of mycological culture samples that were sent for testing. …

Acute and Chronic Respiratory Failure in Cancer Patients

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The Management of Hematopoietic Stem Cell Transplant in People with HIV.

Hematopoietic stem cell transplant (HSCT) is now recognized as a standard treatment option for people with HIV (PWH) who develop high-risk hematologic malignancies. However, the involved polypharmacy can lead to complications from drug interactions and toxicities, affecting the efficacy and safety of chemotherapy and antiretroviral therapy (ART). Managing these patients requires a personalized approach, including the careful selection of ART based on previous therapies and potential interactions, alongside risk assessment for infections. This discussion will address the history of HSCT in PWH

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… Cryptococcosis Cryptococcus neoformans and Cryptococcus gatti are the primary pathogenic species responsible for the infection, and cryptococcal meningitis is a significant complication in PWH. … Cryptococcosis | ▪ Routine surveillance testing for serum CrAg is recommended for patients with CD4+ counts ≤ 100 cells/µL. …

Toxicity management strategies for next-generation novel therapeutics in multiple myeloma.

The therapeutic options available for patients with multiple myeloma have greatly expanded over the past decade and incorporating these novel agents into routine clinical practice has significantly improved outcomes. The next generation of therapeutics is available for relapsed and refractory patients either as standard of care or in clinical trial, and these drugs represent a generational paradigm shift. Patients now have access to a multitude of novel immunotherapeutics, including monoclonal antibodies, an antibody-drug conjugate, chimeric antigen receptor T-cells (CAR-T), and bispecific T-c

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… , 0.1–18.7 months. 42 Atypical infections are uncommon, however, reactivation of herpes zoster and Epstein–Barr virus/cytomegalovirus, pneumocystis jirovecii pneumonia (PJP), progressive multifocal leukoencephalopathy, bronchopulmonary aspergillosis, fungal meningitis, listeriosis, and disseminated cryptococcosis … Disseminated cryptococcosis in a patient with multiple myeloma treated with daratumumab, lenalidomide, and dexamethasone. Intern Med 2019; 58: 843–847. 49. Tabata R, Sato N, Yamauchi N, et al. …

The 2024 Saudi Pharmacotherapy Didactic Curriculum Toolkit: A Modified Delphi Study.

BACKGROUND: Several pharmacy schools in Saudi Arabia (S.A.) refer to the American College of Clinical Pharmacy (ACCP) pharmacotherapy toolkit in developing their pharmacotherapy curriculum. However, the ACCP toolkit does not specifically address the healthcare needs of the Saudi population. A tailored pharmacotherapy curriculum that offers graduates the essential competencies to better serve the nation's needs is warranted. This study aims to develop a population-centered didactic pharmacotherapy toolkit for the Saudi population to assist pharmacy schools in designing pharmacotherapy course co

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… infections (e.g., otitis media, sinusitis, bronchitis, pertussis) 1 Urinary tract infections, uncomplicated 1 Tuberculosis 2 Antimicrobial prophylaxis in surgery and other procedures 2 Bloodstream and catheter infections 2 Bone and joint infections 2 Fungal infections, invasive (e.g., endemic fungus, cryptococcosis … e.g., otitis media, sinusitis, bronchitis, pertussis) 1 | Urinary tract infections, uncomplicated 1 | Tuberculosis 2 | Antimicrobial prophylaxis in surgery and other procedures 2 | Bloodstream and catheter infections 2 | Bone and joint infections 2 | Fungal infections, invasive (e.g., endemic fungus, cryptococcosis …

Transcriptional network of multiple capsule and melanin genes governed by the Cryptococcus neoformans cyclic AMP cascade.

Cryptococcus neoformans is an opportunistic human fungal pathogen that elaborates several virulence attributes, including a polysaccharide capsule and melanin pigments. A conserved Galpha protein/cyclic AMP (cAMP) pathway controls melanin and capsule production. To identify targets of this pathway, we used an expression profiling approach to define genes that are transcriptionally regulated by the Galpha protein Gpa1. This approach revealed that Gpa1 transcriptionally regulates multiple genes involved in capsule assembly and identified two additional genes with a marked dependence on Gpa1 for

Clinical Aspects of B Cell Immunodeficiencies: The Past, the Present and the Future.

B cells and antibodies are indispensable for host immunity. Our understanding of the mechanistic processes that underpin how B cells operate has left an indelible mark on the field of clinical pathology, and recently has also dramatically reshaped the therapeutic landscape of diseases that were once considered incurable. Evaluating patients with primary immunodeficiency diseases (PID)/inborn errors of immunity (IEI) that primarily affect B cells, offers us an opportunity to further our understanding of how B cells develop, mature, function and, in certain instances, cause further disease. In t

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… Lymphonodular Cryptococcosis Diagnosed by Fine Needle Aspiration Cytology in Hyper-IgM Syndrome: A case report Acta Cytol. 2001 45 241 244 10.1159/000327282 11284311 28. de la Morena M.T. Leonard D. Torgerson T.R. Cabral-Marques O. Slatter M. Aghamohammadi A. Chandra S. Murguia-Favela L. … Disseminated cryptococcosis in two boys with novel mutation of CD40 Ligand-Associated X-linked hyper-IgM syndrome Asian Pac. J. Allergy Immunol. 2021 39 31 34 10.12932/AP-140218-0265 30447657 35. Dunn C.P. de la Morena M.T. …