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Cryptococcal disease in patients with or without human immunodeficiency virus: clinical presentation and monitoring of serum cryptococcal antigen titers.
J Microbiol Immunol Infect. 2009 Jun; 42(3):220-6.JM

Abstract

BACKGROUND AND PURPOSE

Cryptococcus neoformans is an encapsulated pathogenic yeast that causes a wide range of clinical manifestations. The serum cryptococcal latex agglutination test is a simple, rapid, and reliable diagnostic test for cryptococcosis. This study was performed to assess the clinical relevance of serum cryptococcal antigen (CRAG) titer in patients with cryptococcosis with or without human immunodeficiency virus (HIV).

METHODS

From January 1999 to December 2007, 45 patients with a diagnosis of cryptococcosis made by culture and/or histopathology were enrolled in this retrospective study. Ten patients had HIV and 35 were not infected.

RESULTS

Patients with HIV were more likely to have central nervous system (CNS) involvement than patients without HIV (100% vs 37.1%; p = 0.0005), higher serum CRAG titers (median, 1:1024 vs 1:64; p < 0.05), higher positive cerebrospinal fluid (CSF) CRAG (100% vs 37.1%; p = 0.0005), and higher CRAG titers in the CSF (median, 1:1024 vs 1:32; p < 0.001). Patients without HIV were more likely to have pulmonary involvement (62.9% vs 0%; p = 0.0005) and no underlying disease at diagnosis (42.9% vs 0%; p = 0.011). Serum CRAG titers among patients without HIV with CNS or pulmonary cryptococcosis declined during treatment and no relapse was noted when serum CRAG titers were <or=1:8 at the end of treatment.

CONCLUSIONS

Serum CRAG titer can be used to monitor disease activity during treatment for CNS and pulmonary cryptococcosis in patients without HIV.

Authors+Show Affiliations

Lin TY
Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Yeh KM
No affiliation info available
Lin JC
No affiliation info available
Wang NC
No affiliation info available
Peng MY
No affiliation info available
Chang FY
No affiliation info available

MeSH

AIDS-Related Opportunistic InfectionsAdolescentAdultAgedAged, 80 and overAntigens, FungalChi-Square DistributionCryptococcosisCryptococcus neoformansFemaleHumansLatex Fixation TestsMaleMiddle AgedRetrospective Studies

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19812855

Citation

Lin, Te-Yu, et al. "Cryptococcal Disease in Patients With or Without Human Immunodeficiency Virus: Clinical Presentation and Monitoring of Serum Cryptococcal Antigen Titers." Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, vol. 42, no. 3, 2009, pp. 220-6.
Lin TY, Yeh KM, Lin JC, et al. Cryptococcal disease in patients with or without human immunodeficiency virus: clinical presentation and monitoring of serum cryptococcal antigen titers. J Microbiol Immunol Infect. 2009;42(3):220-6.
Lin, T. Y., Yeh, K. M., Lin, J. C., Wang, N. C., Peng, M. Y., & Chang, F. Y. (2009). Cryptococcal disease in patients with or without human immunodeficiency virus: clinical presentation and monitoring of serum cryptococcal antigen titers. Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, 42(3), 220-6.
Lin TY, et al. Cryptococcal Disease in Patients With or Without Human Immunodeficiency Virus: Clinical Presentation and Monitoring of Serum Cryptococcal Antigen Titers. J Microbiol Immunol Infect. 2009;42(3):220-6. PubMed PMID: 19812855.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cryptococcal disease in patients with or without human immunodeficiency virus: clinical presentation and monitoring of serum cryptococcal antigen titers. AU - Lin,Te-Yu, AU - Yeh,Kuo-Ming, AU - Lin,Jung-Chung, AU - Wang,Ning-Chi, AU - Peng,Ming-Yieh, AU - Chang,Feng-Yee, PY - 2009/10/9/entrez PY - 2009/10/9/pubmed PY - 2010/3/12/medline SP - 220 EP - 6 JF - Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi JO - J Microbiol Immunol Infect VL - 42 IS - 3 N2 - BACKGROUND AND PURPOSE: Cryptococcus neoformans is an encapsulated pathogenic yeast that causes a wide range of clinical manifestations. The serum cryptococcal latex agglutination test is a simple, rapid, and reliable diagnostic test for cryptococcosis. This study was performed to assess the clinical relevance of serum cryptococcal antigen (CRAG) titer in patients with cryptococcosis with or without human immunodeficiency virus (HIV). METHODS: From January 1999 to December 2007, 45 patients with a diagnosis of cryptococcosis made by culture and/or histopathology were enrolled in this retrospective study. Ten patients had HIV and 35 were not infected. RESULTS: Patients with HIV were more likely to have central nervous system (CNS) involvement than patients without HIV (100% vs 37.1%; p = 0.0005), higher serum CRAG titers (median, 1:1024 vs 1:64; p < 0.05), higher positive cerebrospinal fluid (CSF) CRAG (100% vs 37.1%; p = 0.0005), and higher CRAG titers in the CSF (median, 1:1024 vs 1:32; p < 0.001). Patients without HIV were more likely to have pulmonary involvement (62.9% vs 0%; p = 0.0005) and no underlying disease at diagnosis (42.9% vs 0%; p = 0.011). Serum CRAG titers among patients without HIV with CNS or pulmonary cryptococcosis declined during treatment and no relapse was noted when serum CRAG titers were <or=1:8 at the end of treatment. CONCLUSIONS: Serum CRAG titer can be used to monitor disease activity during treatment for CNS and pulmonary cryptococcosis in patients without HIV. SN - 1995-9133 UR - https://www.unboundmedicine.com/medline/citation/19812855/Cryptococcal_disease_in_patients_with_or_without_human_immunodeficiency_virus:_clinical_presentation_and_monitoring_of_serum_cryptococcal_antigen_titers_ DB - PRIME DP - Unbound Medicine ER -