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1.
Kim JH Shin DH Oh MD Park S Kim BK Choe KW 《Scandinavian journal of infectious diseases》2001,33(3):234-235
Disseminated cryptococcosis is a life-threatening infection caused by Cryptococcus neoformans and cutaneous dissemination occurs in 10-15% of patients. We report a case of a 49-y-old leukemic patient with disseminated cryptococcosis who presented with fever, headache, normal cerebrospinal fluid profile and multiple skin lesions mimicking molluscum contagiosum. 相似文献
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Cryptococcal meningitis presenting with headache and a pustular eruption in a heart transplant patient 下载免费PDF全文
Cryptococcosis is a fungal infection that typically occurs in severely immunocompromised patients. Here, we report the case of a heart transplant recipient who presented with cutaneous lesions and was diagnosed with disseminated cryptococcosis and then cryptococcal meningitis on the basis of positive Tzanck smear of the lesions, confirmed by culture, highlighting the importance of the skin as a window to systemic disease. 相似文献
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Kishida N Okinaka K Fujita T Gu Y Ohmagari N 《Kansenshōgaku zasshi. The Journal of the Japanese Association for Infectious Diseases》2010,84(5):597-601
Cryptococcal lung disease is usually diagnosed by chest X-ray abnormalities. Although no treatment exists for asymptomatically immunocompetent patients, a case with central nervous system (CNS) involvement as cryptococcus dissemination had a new chest X-ray abnormality during marked eosinophilia diagnosed as pulmonary cryptococcosis by lung biopsy. Eosinophilia may thus be associated with pulmonary cryptococcosis. We had seen reports of disseminated cryptococcosis with eosinophilia, so we conducted lumbar puncture and blood culture, but found no disseminated lesion or CNS involvement. Eosinophilia association with disseminated cryptococcosis has been reported, but not pulmonary cryptococcosis with solitary localized lung lesion with marked eosinophilia, making our case the first, in so far as we know reported of pulmonary cryptococcosis with a solitary localized lung lesion with marked eosinophilia. 相似文献
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Summary: Disseminated cryptococcosis with ocular involvement. R. K. Kurnar and A. W. J. Lykke, Aust. N.Z. J. Med., 1979, 9, pp. 444–447.
A case of disseminated cryptococcosis with extensive ocular involvement is reported. The patient had pulmonary, meningeal, cerebral, cutaneous, lymph node, renal, adrenal and thyroid lesions, as well as granulomatous endophthalmitis. 相似文献
A case of disseminated cryptococcosis with extensive ocular involvement is reported. The patient had pulmonary, meningeal, cerebral, cutaneous, lymph node, renal, adrenal and thyroid lesions, as well as granulomatous endophthalmitis. 相似文献
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Although cryptococcosis with lung involvement is not rare in patients with HIV, it is rarely considered in the differential diagnosis of an abnormal chest roentgenogram. Pulmonary cryptococcosis with concomitant opportunistic infections is frequently seen among AIDS and its association with tuberculosis (TB) has been previously reported. Untreated pulmonary cryptococcosis in immunocompromised hosts usually becomes disseminated and results in considerable mortality despite antifungal therapy. We report a case of cryptococcosis with pulmonary involvement in a patient with coexisting disseminated TB in HIV infection. 相似文献
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The ability of tumor necrosis factor (TNF)-α inhibitors to impair pivotal pro-inflammatory host defenses may facilitate the development of disseminated cryptococcosis. Gastrointestinal (GI) tract disease is an unusual presentation of this yeast infection. We describe a unique case of disseminated cryptococcosis presenting as colitis that mimicked an exacerbation of Crohn's disease in a TNF-α inhibitor recipient. Review of existing literature shows that in immunocompromised patients, GI cryptococcosis invariably coexists with disseminated cryptococcosis, often lacks prominent GI symptomatology, and is primarily diagnosed postmortem. In cases with opportunistic infections, discontinuation of TNF-α inhibitors is a common practice, however rapid rebound of inflammatory responses may incur the risk of immune reconstitution syndrome. 相似文献
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肝脏播散性隐球菌病十分罕见,确诊主要依靠病理学及微生物学检查,与累及神经系统、皮肤、肺等组织器官的播散性隐球菌病相比病情更加凶险,确诊难,预后差.本文通过探讨累及肝脏的小儿全身播散性隐球菌病的临床病理特点,以提高对该病的认识及临床诊断治疗水平. 相似文献
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D W Denning R W Armstrong M Fishman D A Stevens 《Reviews of infectious diseases》1991,13(6):1126-1130
We report a case of presumed cryptococcal endophthalmitis that occurred in a patient with severe disseminated cryptococcosis and AIDS. Multiple small, spherical lesions appeared bilaterally on the surface of the retina 2 weeks after cryptococcal meningitis was diagnosed; the lesions were associated with multiple blind spots, blurred vision, and the perception of flaring of light. Over the next week, many more lesions with adjacent hemorrhages appeared. Therapy with itraconazole over the next 3 months resulted in complete resolution of the lesions. Cryptococcal endophthalmitis is a rare disease. Fewer than 20 cases, including five in patients with AIDS, have previously been reported. None of these patients regained normal vision. 相似文献
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Pulmonary cryptococcosis in AIDS 总被引:6,自引:0,他引:6
Cryptococcus neoformans is emerging as an important etiologic agent of disseminated infection in patients with the acquired immunodeficiency syndrome (AIDS). Little attention has been placed on the pulmonary expression of this systemic infection. We report five patients with AIDS and cryptococcosis with primary pulmonary involvement. Patients usually presented with fever, cough, dyspnea, and pleuritic chest pain. Chest x-ray findings varied from localized and diffuse infiltration to lymphadenopathy and pleural effusions. All patients developed disseminated disease despite antifungal therapy. Pulmonary cryptococcosis is a frequent presentation of this infection in patients with AIDS. 相似文献
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R. Godbole P. Nayar A. Pradhan R. Manchanda 《Indian journal of hematology & blood transfusion》2007,23(3-4):122-124
Cryptococcosis is caused by cryptococcus neoformans. Immunosuppression is a predisposing factor for the development of cryptococcosis. However, reports exist that cryptococcus neoformans can cause infection in immunocompetent hosts. We report a case of disseminated cryptococcosis in a 7.5-year-old immunocompetent child. 相似文献
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M H Greene A M Macher A D Hernandez K J Tomecki B Chabner 《Archives of internal medicine》1978,138(9):1412-1413
Disseminated cryptococcosis with palpable purpura as the initial clinical manifestation developed in a patient with diffuse histiocytic lymphoma. Cryptococcal vascular injury in a thrombocytopenic cancer patient best explains this previously unreported presentation of cryptococcosis. Purpuric presentations of disseminated fungal infection are likely to increase in frequency as cancer therapy becomes more aggressive. 相似文献
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Disseminated cryptococcosis presenting as biliary obstruction is rare. We report a 35-year-old HIV-negative man who presented with clinical features suggestive of obstructive jaundice, and radiological features suggestive of Klatskin's tumor, but who ultimately was found to have cryptococcal involvement of the liver and biliary tract as part of disseminated cryptococcosis. The patient responded to antifungal therapy. 相似文献
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Pleural cryptococcosis is extremely rare. We report the first case of cryptococcal pleural effusion in association with the acquired immune deficiency syndrome. Pleural effusion without the evidence of pulmonary parenchymal involvement was the initial and only clinical finding leading to the diagnosis of disseminated cryptococcosis. The pleural effusion resolved spontaneously prior to amphotericin B therapy. 相似文献
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Oliveira Fde M Severo CB Guazzelli LS Severo LC 《Revista do Instituto de Medicina Tropical de S?o Paulo》2007,49(4):263-265
A 64-year-old apparently immunocompetent white man developed lung and brain lesions of disseminated cryptococcosis. The radiologic features mimicked those of lung cancer metastatic to the central nervous system. C. gattii was recovered from cultures of bronchoalveolar lavage fluid, brain biopsy, and blood. The same fungus was recovered from pulmonary and brain specimens at autopsy. Serum and cerebrospinal fluid cryptococcal antigen tests were diagnostic in our case and should be included in the diagnostic evaluation of unexplained pulmonary and cerebral lesions. A literature search showed few reports of fungemia by this species of Cryptococcus, contrasting to C. neoformans. 相似文献
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Jackson LA Drevets DA Dong ZM Greenfield RA Murphy JW 《The Journal of infectious diseases》2005,191(8):1361-1367
Patients with disseminated cryptococcosis typically have measurable levels of cryptococcal polysaccharide in serum samples but minimal leukocyte infiltration into infected tissues. In vitro data have shown that cryptococcal polysaccharide induces L-selectin (CD62L) shedding from leukocytes. To assess shedding in vivo, we compared leukocyte L-selectin levels in human immunodeficiency virus (HIV) type 1-negative and -positive subjects with and without circulating cryptococcal polysaccharide. Results showed that subjects with cryptococcal polysaccharide in serum samples have significantly lower percentages of neutrophils, monocytes, and CD3+ T cells with L-selectin on their surfaces than do healthy subjects, regardless of HIV status. There was significantly more soluble L-selectin in serum samples from subjects with cryptococcosis than in those from uninfected subjects. Reduced L-selectin levels on leukocytes in subjects with circulating cryptococcal polysaccharide and increased serum levels of soluble L-selectin indicates that surface L-selectin shedding is a mechanism that likely explains reduced leukocyte extravasation into infected tissues of patients with disseminated cryptococcosis. 相似文献
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Ferry T Ponceau B Gaultier JB Piens MA Biron F Picot S Chidiac C Peyramond D 《The Journal of infection》2005,51(3):e173-e176
We report the first case in Europe of co-infection with disseminated cryptococcosis and histoplasmosis. The diagnosis of invasive histoplasmosis was confirmed by microscopic examination of the anatomic right colon specimen (hemicolectomy). Histoplasma antigen detection is not yet available in France but it could have a key role in the early diagnosis of disseminated histoplasmosis co-existing with a cryptococcal infection, especially in HIV-infected African people. 相似文献
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Singh N Alexander BD Lortholary O Dromer F Gupta KL John GT del Busto R Klintmalm GB Somani J Lyon GM Pursell K Stosor V Munoz P Limaye AP Kalil AC Pruett TL Garcia-Diaz J Humar A Houston S House AA Wray D Orloff S Dowdy LA Fisher RA Heitman J Wagener MM Husain S;Cryptococcal Collaborative Transplant Study Group 《The Journal of infectious diseases》2007,195(5):756-764
Variables influencing the risk of dissemination and outcome of Cryptococcus neoformans infection were assessed in 111 organ transplant recipients with cryptococcosis in a prospective, multicenter, international study. Sixty-one percent (68/111) of the patients had disseminated infection. The risk of disseminated cryptococcosis was significantly higher for liver transplant recipients (adjusted hazard ratio [HR], 6.65; P=.048). The overall mortality rate at 90 days was 14% (16/111). The mortality rate was higher in patients with abnormal mental status (P=.023), renal failure at baseline (P=.028), fungemia (P=.006), and disseminated infection (P=.035) and was lower in those receiving a calcineurin-inhibitor agent (P=.003). In a multivariable analysis, the receipt of a calcineurin-inhibitor agent was independently associated with a lower mortality (adjusted HR, 0.21; P=.008), and renal failure at baseline with a higher mortality rate (adjusted HR, 3.14; P=.037). Thus, outcome in transplant recipients with cryptococcosis appears to be influenced by the type of immunosuppressive agent employed. Additionally, discerning the basis for transplant type-specific differences in disease severity has implications relevant for yielding further insights into the pathogenesis of C. neoformans infection in transplant recipients. 相似文献
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Deep fungal infection in systemic lupus erythematosus - three cases reported, literature reviewed. 总被引:3,自引:0,他引:3
Three patients with systemic lupus erythematosus (SLE) and deep fungal infection are described. Two patients had disseminated cryptococcal infection and the third disseminated histoplasmosis. Allwere receiving corticosteroids at the time fungal infection developed. One patient with disseminated cryptococcosis improved after treatment with amphotericin B and 5-fluorocytosine. The other patient with disseminated cryptococcosis died before adequate therapy could be given. The patient with histoplasmosis responded satisfactorily to amphotericin B. A survey of the literature revealed 30 additional cases of deep fungal infection in patients with SLE, most of whom were on corticosteroid therapy. The majority of the patients had candidiasis (14 patients); 11 patients had severe cryptococcal infection. Other fungal infections reported were histoplasmosis, aspergillois, coccidioidomycosis, and maduromycosis caused by Allerscheria boydii. Twenty-seven patients died; in 22 death was related to the fungal infection. The fungal infection was not diagnosed until necropsy in at least 11 persons. Deep fungal infections should be considered whenever patients with SLE have fever of unknown origin, diffuse pulmonary infiltrates, or unexplained CNS symptoms. 相似文献