Incidence and clinical outcome of Cryptococcosis in a nation with advanced HIV surveillance program

Abstract

Background: Cryptococcosis is a major opportunistic invasive mycosis that mostly affects immunocompromised patients. Methods: This was an observational study of all culture-confirmed cases of cryptococcosis conducted in the State of Qatar from January 2005 to December 2016. Cryptococcus fungi were identified using Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS). Results: Fourteen culture-confirmed cases of cryptococcosis were identified during the study period. Four patients had a Human Immunodeficiency Virus (HIV) infection with low CD4 count and five were receiving immunosuppressant medications. The rest of the patients were apparently immuno-competent. The central nervous system was the most common site of infection (57%) followed by bloodstream infection (36%) and pneumonia (14%). One patient had a cryptococcal scrotal infection. Twelve isolates were Cryptococcus neoformans and 2 were Cryptococcus laurentii. All isolates were within the wild type ECV values to amphotericin B and fluconazole. Only 2 patients with bloodstream infection (HIV negative) died. The rest were cured of the infection. Conclusion: Cryptococcosis is a rare fungal disease in the State of Qatar, mostly diagnosed in Asian immigrants. The central nervous system is the most common site of infection. The presence of the fungus in the blood carries a high mortality.

Exploring salivary metabolome alterations in people with HIV: towards early diagnostic markers

“…4.4 Indoles and L-glutamine may exhibit antagonistic effects against HSV-1, bacteria, and fungi PLWH are susceptible to bacterial infections, a factor that further complicates their condition (43). Additionally, certain fungi can exert a detrimental impact on immunocompromised patients, frequently leading to invasive diseases (44). Moreover, HSV-1 infection increases the incidence of HIV-related illnesses (45).…”

Cryptococcal meningitis in Qatar: A hospital based study from 2005-2015

“…other forms of immunosuppression as well as immunocompetent individuals may also be affected. [1][2][3] In humans, C. neoformans infection is acquired by inhalation of aerosolized particles containing yeasts or spores from the environment. In immunocompetent individuals, the resulting lung infection is often asymptomatic, and the initial lung infection site is normally healed or contained within granulomata that reflect a latent infection.…”

“…[5,6] Although there is a marked increase in the incidence of CM around the world due to its association with AIDS, reports concerning this infection in the Arab countries, including Qatar, are limited. [2] The study aimed to estimate the prevalence of CM and describe its clinical profile, laboratory parameters, and outcomes in patients with CM in Qatar.…”