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Size Matters: Measurement of Capsule Diameter in Cryptococcus neoformans
08:24

Size Matters: Measurement of Capsule Diameter in Cryptococcus neoformans

Published on: February 27, 2018

Non-neoformans cryptococcal infections: a systematic review

T Khawcharoenporn1, A Apisarnthanarak, L M Mundy

  • 1Division of Infectious Diseases, Faculty of Medicine, Thammasart University Hospital, Pratumthani, 12120, Thailand. anapisarn@yahoo.com

Infection
|April 3, 2007
PubMed

Insights

Non-neoformans cryptococcal infections, often caused by Cryptococcus laurentii and Cryptococcus albidus, are increasingly reported. Invasive devices and impaired immunity are risk factors, necessitating a high index of suspicion for early diagnosis and treatment.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Non-neoformans cryptococci, previously considered harmless saprophytes, are emerging as significant human pathogens.
  • Cryptococcus laurentii and Cryptococcus albidus account for 80% of non-neoformans cryptococcal infections.
  • Impaired cell-mediated immunity and prior azole prophylaxis are identified risk factors.

Purpose of the Study:

  • To investigate the epidemiology and risk factors associated with non-neoformans cryptococcal infections.
  • To identify predictors of mortality in patients with non-neoformans cryptococcal infections.
  • To emphasize the importance of early diagnosis and treatment due to overlapping clinical presentations with Cryptococcus neoformans.

Main Methods:

  • Retrospective analysis of clinical data from patients with non-neoformans cryptococcal infections.
  • Statistical analysis including adjusted odds ratios (aOR) and confidence intervals (CI) to determine risk factors and mortality predictors.
  • Comparison of clinical manifestations with Cryptococcus neoformans infections.

Main Results:

  • The presence of invasive devices was a significant risk factor for Cryptococcus laurentii infection (aOR = 8.7).
  • Mortality predictors included age ≥45 years (aOR = 8.4) and meningeal presentation (aOR = 7.0).
  • Clinical presentations are often indistinguishable from Cryptococcus neoformans infections.

Conclusions:

  • Non-neoformans cryptococci represent a growing threat, particularly in immunocompromised individuals and those with invasive devices.
  • Prompt diagnosis and treatment are crucial, requiring a high index of suspicion due to non-specific clinical signs.
  • Further research into optimal management strategies for these emerging fungal infections is warranted.

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