Related Experiment Video
Updated: Feb 4, 2026
08:08
Automated Measurement of Cryptococcal Species Polysaccharide Capsule and Cell Body
Published on: January 11, 2018
7.8K
Symptomatic Cryptococcal Antigenemia Presenting as Early Cryptococcal Meningitis With Negative Cerebral Spinal Fluid
Kenneth Ssebambulidde1, Ananta S Bangdiwala2, Richard Kwizera1
1Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
Summary
Cryptococcal antigenemia with neurological symptoms but negative CSF CrAg is a distinct entity, potentially early meningoencephalitis. In-hospital mortality was similar to cryptococcal meningitis, suggesting a need for revised treatment strategies.
Area of Science:
- Infectious Diseases
- Neurology
- Clinical Microbiology
Background:
- Cryptococcal antigenemia poses a high risk for cryptococcal meningitis.
- The progression from asymptomatic infection to meningitis is not well understood.
- This study identifies a subpopulation with neurological symptoms and antigenemia but negative cerebrospinal fluid (CSF) studies.
Purpose of the Study:
- To characterize individuals with neurological symptoms and cryptococcal antigenemia but negative CSF cryptococcal antigen (CrAg) tests.
- To compare their clinical outcomes with those of confirmed cryptococcal meningitis.
- To investigate potential early meningoencephalitis in this population.
Main Methods:
- Evaluated 1201 HIV-seropositive individuals hospitalized with suspected meningitis in Uganda.
- Compared baseline characteristics and outcomes of patients with neurologic-symptomatic antigenemia and negative CSF CrAg to those with confirmed CSF CrAg+ meningitis.
- Performed extensive CSF testing, including microscopy, fungal/bacterial/tuberculosis cultures, and PCR (FilmArray, Xpert MTB/Rif).
Main Results:
- 4% (54/1201) had neurologic symptomatic antigenemia with negative CSF CrAg; 9% had Cryptococcus cultured or detected by PCR.
- 11% of CSF CrAg-negative patients had confirmed tuberculous meningitis.
- CSF CrAg-negative patients showed lower rates of pleocytosis and elevated opening pressure compared to CrAg-positive patients; in-hospital mortality was similar (32% vs 31%).
Conclusions:
- Neurologic symptomatic cryptococcal antigenemia with negative CSF CrAg was the third most common meningitis etiology, possibly representing early meningoencephalitis.
- Fluconazole monotherapy was suboptimal in this group, even with negative CSF.
- Further research is needed to define the clinical course and optimal management of this condition.
More Related Videos
Related Concept Videos
01:19Cranial and Spinal Meninges
4.1K
The cranial and spinal meninges are complex protective structures surrounding the central nervous system (CNS), consisting of the brain and spinal cord. These meninges consist of the dura mater, the arachnoid mater, and the pia mater. They protect the CNS, provide structural support, and aid in circulating cerebrospinal fluid (CSF).
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
4.1K
01:23Negative Regulator Molecules
38.5K
Positive regulators allow a cell to advance through cell cycle checkpoints. Negative regulators have an equally important role as they terminate a cell’s progression through the cell cycle—or pause it—until the cell meets specific criteria.
38.5K
00:58Positive, Negative, and Zero Work
22.2K
Work is done on an object when energy is transferred to the object. In other words, work is done when a force acts on a body that undergoes a displacement from one position to another. By definition, the work done by a force is the integral of the force with respect to the displacement along its path. Forces can vary as a function of position, and displacements can occur along various paths between two points. The magnitude of a force multiplied by the cosine of the angle that the force makes...
22.2K
01:34The Fluid Mosaic Model
178.4K
The fluid mosaic model was first proposed as a visual representation of research observations. The model comprises the composition and dynamics of membranes and serves as a foundation for future membrane-related studies. The model depicts the structure of the plasma membrane with a variety of components, which include phospholipids, proteins, and carbohydrates. These integral molecules are loosely bound, defining the cell’s border and providing fluidity for optimal function.
178.4K
01:30Negative and Cognitive Symptoms of Schizophrenia
580
Negative symptoms of schizophrenia indicate a reduction or absence of typical behaviors and emotional responses found in healthy individuals, while positive symptoms reflect an excess or distortion of normal functioning.
Negative Symptoms
Negative symptoms of schizophrenia manifest as deficits in normal emotional and behavioral functioning, profoundly impacting daily life. Individuals with schizophrenia often display a flat affect, characterized by a near-total absence of emotional expression,...
Negative Symptoms
Negative symptoms of schizophrenia manifest as deficits in normal emotional and behavioral functioning, profoundly impacting daily life. Individuals with schizophrenia often display a flat affect, characterized by a near-total absence of emotional expression,...
580
01:14Fluid Pressure
1.2K
In mechanical engineering, fluid pressure plays a critical role in designing systems that utilize liquid flow, such as hydraulic systems, pumps, and valves. When designing these systems, engineers must ensure they can withstand the forces created by fluid pressure to avoid damage or failure.
According to Pascal's law, a fluid at rest will generate equal pressure in all directions. This pressure is measured as a force per unit area, and its magnitude depends on the fluid's specific...
According to Pascal's law, a fluid at rest will generate equal pressure in all directions. This pressure is measured as a force per unit area, and its magnitude depends on the fluid's specific...
1.2K