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Prostatic sequestration of Cryptococcus neoformans in immunocompromised persons treated for cryptococcal
O K Ndimbie1, A Dekker, A J Martinez
1Department of Pathology, University of Pittsburgh Medical Center, Pennsylvania.
Histology and Histopathology
|October 1, 1994
Summary
In patients with acquired immune deficiency syndrome (AIDS), the prostate may harbor Cryptococcus neoformans, potentially leading to cryptococcal meningoencephalitis relapse. Autopsy findings suggest the prostate as a potential sanctuary site for this fungal pathogen.
Area of Science:
- Infectious Diseases
- Immunology
- Urology
Background:
- Acquired immune deficiency syndrome (AIDS) increases susceptibility to opportunistic infections.
- Cryptococcal meningoencephalitis is a serious complication in individuals with advanced HIV/AIDS.
- Standard treatment involves antifungal agents like amphotericin B and 5-flucytosine.
Observation:
- A case of successful cryptococcal meningoencephalitis treatment in an AIDS patient was followed by death from other AIDS sequelae.
- Autopsy revealed significant cryptococcal prostatitis, with no fungi detected in the central nervous system or elsewhere.
- Seven additional cases of men with prior cryptococcal meningoencephalitis were identified in autopsy files.
Findings:
- The prostate may act as a sanctuary site for Cryptococcus neoformans.
- Fungal sequestration in the prostate could contribute to systemic relapse of cryptococcal infections.
- Criteria for prostatic sequestration include positive fungal cultures from the prostate or post-massage urine, with the prostate being the sole infection focus.
Implications:
- This suggests a need to investigate the prostate as a reservoir for Cryptococcus neoformans in immunocompromised patients.
- Understanding prostatic sequestration may inform strategies to prevent cryptococcal disease recurrence in AIDS patients.
- Further research is warranted to confirm the role of the prostate in cryptococcal infections and relapses.