Paradoxical inflammatory reaction during treatment of Cryptococcus neoformans var. gattii meningitis in an HIV-seronegative woman

被引:54
作者
Einsiedel, L [1 ]
Gordon, DL [1 ]
Dyera, JR [1 ]
机构
[1] Flinders Med Ctr, Dept Microbiol & Infect Dis, Bedford Pk, SA, Australia
关键词
D O I
10.1086/424746
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
A human immunodeficiency virus (HIV)-seronegative woman was admitted to the hospital with postpartum onset Cryptococcus neoformans var. gattii meningitis and markedly increased intracranial pressure. A poor initial response to antifungal therapy was followed, 2 months after hospital admission, by severe acute meningeal and cerebral inflammation and clearance of yeast cells from cerebrospinal fluid. This first reported case of paradoxical inflammatory reaction to C. neoformans illustrates important aspects of the host-pathogen interaction and highlights possible effects of immunomodulatory therapies.
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页码:E78 / E82
页数:5
相关论文
共 17 条
[1]   What makes Cryptococcus neoformans a pathogen? [J].
Buchanan, KL ;
Murphy, JW .
EMERGING INFECTIOUS DISEASES, 1998, 4 (01) :71-83
[2]   Paradoxical response to anti-tuberculous drugs: Resolution with corticosteroid therapy [J].
Bukharie, H .
SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES, 2000, 32 (01) :96-97
[3]   Cytokine profiles in cerebrospinal fluid of human immunodeficiency virus-infected patients with cryptococcal meningitis: No leukocytosis despite high interleukin-8 levels [J].
Chaka, W ;
Heyderman, R ;
Gangaidzo, I ;
Robertson, V ;
Mason, P ;
Verhoef, J ;
Verheul, A ;
Hoepelman, AIM .
JOURNAL OF INFECTIOUS DISEASES, 1997, 176 (06) :1633-1636
[4]   Epidemiology and host- and variety-dependent characteristics of infection due to Cryptococcus neoformans in Australia and New Zealand [J].
Chen, S ;
Sorrell, T ;
Nimmo, G ;
Speed, B ;
Currie, B ;
Ellis, D ;
Marriott, D ;
Pfeiffer, T ;
Parr, D ;
Byth, K .
CLINICAL INFECTIOUS DISEASES, 2000, 31 (02) :499-508
[5]   Cryptococcal polysaccharides bind to CD18 on human neutrophils [J].
Dong, ZM ;
Murphy, JW .
INFECTION AND IMMUNITY, 1997, 65 (02) :557-563
[6]   EFFECTS OF THE 2 VARIETIES OF CRYPTOCOCCUS-NEOFORMANS CELLS AND CULTURE FILTRATE ANTIGENS ON NEUTROPHIL LOCOMOTION [J].
DONG, ZM ;
MURPHY, JW .
INFECTION AND IMMUNITY, 1995, 63 (07) :2632-2644
[7]   PCR PRIMERS AND PROBES FOR THE 16S RIBOSOMAL-RNA GENE OF MOST SPECIES OF PATHOGENIC BACTERIA, INCLUDING BACTERIA FOUND IN CEREBROSPINAL-FLUID [J].
GREISEN, K ;
LOEFFELHOLZ, M ;
PUROHIT, A ;
LEONG, D .
JOURNAL OF CLINICAL MICROBIOLOGY, 1994, 32 (02) :335-351
[8]   DEVELOPMENT OF POLYMERASE CHAIN-REACTION ASSAYS FOR DETECTION OF LISTERIA-MONOCYTOGENES IN CLINICAL CEREBROSPINAL-FLUID SAMPLES [J].
JATON, K ;
SAHLI, R ;
BILLE, J .
JOURNAL OF CLINICAL MICROBIOLOGY, 1992, 30 (08) :1931-1936
[9]   Immune reconstitution cryptococcosis after initiation of successful highly active antiretroviral therapy [J].
Jenny-Avital, ER ;
Abadi, M .
CLINICAL INFECTIOUS DISEASES, 2002, 35 (12) :E128-E133
[10]   Cryptococcal glucuronoxylomannan induces interleukin (IL)-8 production by human microglia but inhibits neutrophil migration toward IL-8 [J].
Lipovsky, MM ;
Gekker, G ;
Hu, SX ;
Ehrlich, LC ;
Hoepelman, AIM ;
Peterson, PK .
JOURNAL OF INFECTIOUS DISEASES, 1998, 177 (01) :260-263