A case of disseminated cryptococcal disease after Bruton tyrosine kinase inhibitor therapy: A brief review in the Australian context

Rooij, Nicholas Van; Johnston, Jesse A.; Mortimore, Rohan; Robertson, Ivan

doi:10.1016/j.jdcr.2021.04.022

Cited by 3 publications

(3 citation statements)

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“…50 Oral cryptococcosis usually presents as multiple ulceration, nodules and a granulomatous appearance, with the palate and tongue being the main affected sites. 17,18,[20][21][22][23][24][25][26]28,[30][31][32]38,41,42,43 As in the current report, cryptococcal infection can also present with nonhealing tooth extraction wounds. 22,40 Najjar et al 23 documented an example of disseminated cryptococcosis involving the labial, nasal, and palatal regions in which the diagnostic difficulty was due to the concomitant presence of mature T/natural killer cell lymphoma.…”

Section: Discussionmentioning

confidence: 82%

“…Data on the oral manifestations of cryptococcosis are sparse in the literature, with 26 reports documented hitherto. 17,18,20–43 Men were affected in almost 85%, with a peak incidence in the fourth, fifth, and seventh decades of life. It is known that individuals vulnerable to cryptococcosis are those with advanced HIV/AIDS, either because they are unaware of their serological status or because they are not on adequate antiretroviral therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Twenty-six studies comprising 26 affected individuals met the eligibility criteria and were analyzed. 17,18,20–43 The articles were from the United States, 17,20–26,28,32–36 Peru, 29 Brazil, 30 Colombia, 38 Trinidad and Tobago, 41 Argentina, 43 Germany, 27 The Netherlands, 18 Malaysia, 31 Japan, 37,40 Indonesia, 39 and Australia 42 (Table 2).…”

Section: Literature Reviewmentioning

confidence: 99%

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Orofacial Cryptococcosis: A Challenging Clinical Report and a Systematic Analysis of the Literature

et al. 2023

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Cryptococcosis is a neglected fungal disease. The scarcity of studies on oral cryptococcosis is certainly due to rarity and/or underreporting of the disease, especially in Brazil. We describe an example of orofacial cryptococcosis affecting a 57-year-old man after heart transplantation, who presented with multiple erythematous ulcers and erosions distributed in the chin, nasal cavity, labial mucosa, hard palate, and buccal vestibule. Computed tomography revealed opacities and micronodules in the lungs. Histopathological features of the oral and pulmonary lesions were compatible with Cryptococcus spp. Amphotericin B and fluconazole were used for treatment during hospitalization and itraconazole for prolonged therapy after hospital discharge. The patient has been under follow up for 6 months without signs of disease. According to a review conducted in PubMed, Web of Science, Scopus, Embase, and LILACS for data analysis of oral cryptococcosis, 26 reports were described in the literature. Predilection for men was observed (85%), with a male:female ratio of 5.5:1. The mean age of the individuals was 49 ± 15.3 years. Oral cryptococcosis mostly presented as an ulcer ( n = 17). The palate and tongue were the most affected sites ( n = 9 for each). Amphotericin B was the primary therapy utilized in most patients. Seventeen (65%) individuals survived. Knowledge of the clinicodemographic aspects of oral cryptococcosis is important for clinicians in decision making and surveillance.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

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Orofacial Cryptococcosis: A Challenging Clinical Report and a Systematic Analysis of the Literature

et al. 2023

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Ibrutinib

2021

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Cryptococcosis Associated With Biologic Therapy: A Narrative Review

Li,

Paccoud,

Chan

et al. 2024

Open Forum Infectious Diseases

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Cryptococcus is an opportunistic fungal pathogen that can cause disseminated infection with predominant central nervous system involvement in patients with compromised immunity. Biologics are increasingly used in the treatment of neoplasms and autoimmune/inflammatory conditions and the prevention of transplant rejection, which may affect human defense mechanisms against cryptococcosis. In this review, we comprehensively investigate the association between cryptococcosis and various biologics, highlighting their risks of infection, clinical manifestations, and clinical outcomes. Clinicians should remain vigilant for the risk of cryptococcosis in patients receiving biologics that affect the Th1/macrophage activation pathways, such as tumor necrosis factor α antagonists, Bruton tyrosine kinase inhibitors, fingolimod, JAK/STAT inhibitors (Janus kinase/signal transducer and activator of transcription), and monoclonal antibody against CD52. Other risk factors—such as age, underlying condition, and concurrent immunosuppressants, especially corticosteroids—should also be taken into account during risk stratification.

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A case of disseminated cryptococcal disease after Bruton tyrosine kinase inhibitor therapy: A brief review in the Australian context

Cited by 3 publications

References 7 publications

Orofacial Cryptococcosis: A Challenging Clinical Report and a Systematic Analysis of the Literature

Orofacial Cryptococcosis: A Challenging Clinical Report and a Systematic Analysis of the Literature

Ibrutinib

Cryptococcosis Associated With Biologic Therapy: A Narrative Review

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