Cryptococcal Infection of the Ventriculoperitoneal Shunt in an HIV-Infected Patient with an Excellent Immunovirologic Status

Genebat, Miguel; Mayorga-Buiza, María José; Castillo-Ojeda, Esperanza; Rivero-Garvía, Mónica; Márquez-Rivas, Javier; Me, Jiménez-Mejías

doi:10.1016/j.wneu.2016.12.100

Cited by 6 publications

(4 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 10 , 17 , 30 , 60 Only one case of abdominal seeding of cryptococcal infection was reported, 21 despite this being considered a major complication in previous literature. 12 , 13 , 27 , 61 A single study compared outcomes among shunt types: mortality was higher in the VPS group than in the AVS group. 24 However, small sample sizes limit the utility of this finding.…”

Section: Discussionmentioning

confidence: 99%

Cerebrospinal fluid shunting for the management of cryptococcal meningitis: a scoping review

Cornejo-Venegas,

Carreras,

Salcedo

et al. 2024

Therapeutic Advances in Infection

View full text Add to dashboard Cite

Objective: This scoping review aimed to describe studies that evaluate the management of cryptococcal meningitis (CM) using cerebrospinal fluid (CSF) shunts, types of shunts used, and clinically relevant patient outcomes. Methods: We searched in the following databases: PubMed, Web of Science/Core collection, Embase, the Cochrane Library, and clinicaltrials.gov on 1 April 2022. We included two-arm and one-arm cohort studies that evaluated clinically relevant patient outcomes. Case reports were used to describe the type of CSF shunts used and the rationale behind its selection. The selection and extraction processes were independently performed by two authors. Results: This study included 20 cohort studies and 26 case reports. Only seven cohort studies compared two groups. Ventriculoperitoneal shunt was the most commonly used type of shunt (82.1%). The main indications for placing a shunt were persistently high opening pressure (57.1%) and persisting neurological symptoms or deterioration (54.3%). Cohort studies suggest that patients with shunt showed improvement in some outcomes such as neurological symptoms and hospital stay length. The most common shunt complications were post-operative fever (1–35.6%) and shunt obstruction (7–16%). Conclusion: CSF shunts may improve some clinically relevant outcomes in patients with CM, but the evidence is very uncertain.

show abstract

Section: Discussionmentioning

confidence: 99%

Cerebrospinal fluid shunting for the management of cryptococcal meningitis: a scoping review

Cornejo-Venegas,

Carreras,

Salcedo

et al. 2024

Therapeutic Advances in Infection

View full text Add to dashboard Cite

show abstract

“…Chronic, undiagnosed C. gattii meningitis following the VP shunt placement lead to multiple recurrent communicating hydrocephalus, and eventually resulted in a cryptococcal intraabdominal VP shunt pseudocyst. A summary of nine case reports of cryptococcal VP shunt infection including the present case is provided in Table 1 [ 9 – 14 ]. Only three patients had immunodeficient conditions such as HIV infection (2) and diabetes mellitus with liver cirrhosis (1), while the six cases left had no apparent immunodeficient states.…”

Section: Discussionmentioning

confidence: 99%

Undiagnosed Cryptococcus gattii meningitis leading to subsequent ventriculoperitoneal shunt infection in a patient with symptoms of normal pressure hydrocephalus: case report and literature review

2018

View full text Add to dashboard Cite

BackgroundCryptococcus gattii is known to be an etiologic agent of human cryptococcosis, particularly in immunocompetent persons. C. gattii infection usually involves the central nervous system, the respiratory tract, or may be disseminated. Here we report an atypical manifestation of C. gattii infection in a patient who had C. gattii meningitis complicating the ventriculoperitoneal (VP) shunt infection and concurrent infected intraabdominal VP shunt pseudocyst.Case presentationA 66-year-old Thai female was initially diagnosed with normal pressure hydrocephalus (NPH) and underwent programmable VP shunt placement. However, she still suffered from recurrent communicating hydrocephalus with in-place VP shunt, and later developed recurrent gait impairment, chronic abdominal pain and abdominal mass. Radiological studies demonstrated recurrent hydrocephalus and a very large intraabdominal VP shunt pseudocyst. C. gattii was isolated from both the cerebrospinal fluid and the pseudocyst aspiration. C. gattii meningitis complicating the VP shunt infection and concurrent infected intraabdominal VP shunt pseudocyst was diagnosed. Prolonged antifungal therapy, removal of the infected VP shunt with subsequent implant of a new shunt provided a good outcome.ConclusionChronic C. gattii meningitis should be aware in a patient presenting with normal pressure hydrocephalus. Under-diagnosed cryptococcal meningitis following VP shunt insertion for treating the hydrocephalus can render a complicated VP shunt infection including infected VP shunt pseudocyst.

show abstract

“…Cryptococcus spp. may form biofilms on polystyrene plates and medical devices [ 32 , 33 ] and may be more resistant to amphotericin B and caspofungin [ 25 ]. The evaluation of viable cells is a direct method that allows quantifying the yeasts that present cell viability after treatment with a drug [ 27 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Control ofCryptococcus GattiiBiofilms by an Ethanolic Extract ofCochlospermum Regium(Schrank) Pilger Leaves

Almeida-Apolonio

Cupozak-Pinheiro

Berres

et al. 2018

The Scientific World Journal

View full text Add to dashboard Cite

Cryptococcus gattii is an etiologic agent of cryptococcosis and a serious disease that affects immunocompromised and immunocompetent patients worldwide. The therapeutic arsenal used to treat cryptococcosis is limited to a few antifungal agents, and the ability of C. gattii to form biofilms may hinder treatment and decrease its susceptibility to antifungal agents. The objective of this study was to evaluate the antifungal and antibiofilm activities of an ethanolic extract of Cochlospermum regium (Schrank) Pilger leaves against C. gattii. The antifungal activity was assessed by measuring the minimum inhibitory concentration (MIC) using the broth microdilution technique and interaction of the extract with fluconazole was performed of checkerboard assay. The antibiofilm activity of the extract was evaluated in 96-well polystyrene microplates, and the biofilms were quantified by counting colony forming units. The extract showed antifungal activity at concentrations of 62.5 to 250 μg/mL and when the extract was evaluated in combination with fluconazole, C. gattii was inhibited at sub-MIC levels. The antibiofilm activity of the extract against C. gattii was observed both during biofilm formation and on an already established biofilm. The results showed that the ethanolic extract of the leaves of C. regium shows promise for the development of antifungal drugs to treat cryptococcosis and to combat C. gattii biofilms.

show abstract

Cryptococcal Infection of the Ventriculoperitoneal Shunt in an HIV-Infected Patient with an Excellent Immunovirologic Status

Cited by 6 publications

References 7 publications

Cerebrospinal fluid shunting for the management of cryptococcal meningitis: a scoping review

Cerebrospinal fluid shunting for the management of cryptococcal meningitis: a scoping review

Undiagnosed Cryptococcus gattii meningitis leading to subsequent ventriculoperitoneal shunt infection in a patient with symptoms of normal pressure hydrocephalus: case report and literature review

Control ofCryptococcus GattiiBiofilms by an Ethanolic Extract ofCochlospermum Regium(Schrank) Pilger Leaves

Contact Info

Product

Resources

About