Tongue lesion due to Cryptococcus neoformans as the first finding in an HIV-positive patient

Santiso, Gabriela; Messina, Fernando; Gallo, Andrea; Marín, Emmanuel; Depardo, Roxana; Arechavala, Alicia; Walker, Laura; Negroni, Ricardo; Romero, M. Carolina

doi:10.1016/j.riam.2020.10.003

Cited by 4 publications

(9 citation statements)

References 15 publications

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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: 83%

“…Twenty-six studies comprising 26 affected individuals met the eligibility criteria and were analyzed. 17,18, The articles were from the United States, 17,[20][21][22][23][24][25][26]28,[32][33][34][35][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). The mean age of affected participants was 49 (±15.3) years, ranging from 25 to 81 years, with a peak in the fourth and fifth (n = 6/23%, each) and seventh (n = 6/ 23%) decades of life.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Serological tests with latex agglutination (n = 4) were used in serum and/or cerebrospinal fluid samples. 30,37,38,43 Regarding treatment, amphotericin B was used in 15 patients, associated with fluconazole (n = 10), flucytosine (n = 7), and ketoconazole (n = 1). Also, fluconazole (n = 6), itraconazole (n = 1), and ketoconazole (n = 1) were used as monotherapy.…”

Section: Literature Reviewmentioning

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: 83%

Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

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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“…Other species reported in the literature as promotors for candidiasis occurrence are C. glabrata , C. tropicalis , C. pseudotropicalis , C. krusei , C. lusitaniae , C. dubliniensis , C. parapsilosis , or C. stellatoidea [ 16 , 20 ]. In severe cases related to immunocompromised diseases, pathogens such as Cryptococcus neoformans were found to produce unexpected tongue lesions in an HIV patient [ 23 ], while mucormycosis caused by mucormycetes was recently reported with a high incidence in COVID-19 patients [ 24 , 25 ], along with candidiasis [ 26 ]. The newly developed infections that occurred in the new context of the COVID-19 pandemic were analyzed as multifactorial cases, and an immediate action was taken to combat fungi resistance and avoid the death of hospitalized patients.…”

Section: Oral Health and Candidiasis Developmentmentioning

confidence: 99%

Molecular Mapping of Antifungal Mechanisms Accessing Biomaterials and New Agents to Target Oral Candidiasis

Anuța

Talianu

Dinu-Pîrvu

et al. 2022

IJMS

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Oral candidiasis has a high rate of development, especially in immunocompromised patients. Immunosuppressive and cytotoxic therapies in hospitalized HIV and cancer patients are known to induce the poor management of adverse reactions, where local and systemic candidiasis become highly resistant to conventional antifungal therapy. The development of oral candidiasis is triggered by several mechanisms that determine oral epithelium imbalances, resulting in poor local defense and a delayed immune system response. As a result, pathogenic fungi colonies disseminate and form resistant biofilms, promoting serious challenges in initiating a proper therapeutic protocol. Hence, this study of the literature aimed to discuss possibilities and new trends through antifungal therapy for buccal drug administration. A large number of studies explored the antifungal activity of new agents or synergic components that may enhance the effect of classic drugs. It was of significant interest to find connections between smart biomaterials and their activity, to find molecular responses and mechanisms that can conquer the multidrug resistance of fungi strains, and to transpose them into a molecular map. Overall, attention is focused on the nanocolloids domain, nanoparticles, nanocomposite synthesis, and the design of polymeric platforms to satisfy sustained antifungal activity and high biocompatibility with the oral mucosa.

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Cryptococcus neoformans and Cryptococcus gattii Species Complexes in Latin America: A Map of Molecular Types, Genotypic Diversity, and Antifungal Susceptibility as Reported by the Latin American Cryptococcal Study Group

Firacative

Meyer

Castañeda

2021

JoF

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Cryptococcosis, a potentially fatal mycosis, is caused by members of the Cryptococcus neoformans and Cryptococcus gattii species complexes. In Latin America, cryptococcal meningitis is still an important health threat with a significant clinical burden. Analysis of publicly available molecular data from 5686 clinical, environmental, and veterinary cryptococcal isolates from member countries of the Latin American Cryptococcal Study Group showed that, as worldwide, C. neoformans molecular type VNI is the most common cause of cryptococcosis (76.01%) in HIV-infected people, followed by C. gattii molecular type VGII (12.37%), affecting mostly otherwise healthy hosts. These two molecular types also predominate in the environment (68.60% for VNI and 20.70% for VGII). Among the scarce number of veterinary cases, VGII is the predominant molecular type (73.68%). Multilocus sequence typing analysis showed that, in Latin America, the C. neoformans population is less diverse than the C. gattii population (D of 0.7104 vs. 0.9755). Analysis of antifungal susceptibility data showed the presence of non-wild-type VNI, VGI, VGII, and VGIII isolates in the region. Overall, the data presented herein summarize the progress that has been made towards the molecular epidemiology of cryptococcal isolates in Latin America, contributing to the characterization of the genetic diversity and antifungal susceptibility of these globally spreading pathogenic yeasts.

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Tongue lesion due to Cryptococcus neoformans as the first finding in an HIV-positive patient

Cited by 4 publications

References 15 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

Molecular Mapping of Antifungal Mechanisms Accessing Biomaterials and New Agents to Target Oral Candidiasis

Cryptococcus neoformans and Cryptococcus gattii Species Complexes in Latin America: A Map of Molecular Types, Genotypic Diversity, and Antifungal Susceptibility as Reported by the Latin American Cryptococcal Study Group

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