Allery to pets

Summary More than half of households have a pet. Dogs and cats are by far the most numerous. Among individuals exposed to pets, allergic symptoms can be demonstrated in 5 to 38% of them. The highest figures are demonstrated in individuals exposed to cats. Cat allergen, which originates mainly from saliva but also from the skin, is ubiquitous and remains for a long period of time even if the cat is removed. The allergic potency of each dog breed seems different. Exposure to guinea pigs and hamsters has decreased and represents a health hazard mainly in laboratory workders.     

Ten Challenges on Cryptococcus and Cryptococcosis

Cryptococcosis has become a significant public global health problem worldwide. Caused by two species, Cryptococcus neoformans or Cryptococcus gattii, this life-threatening infection afflicts not only immunocompromised individuals but also apparently immunocompetent subjects. Hence, cryptococcosis should no longer be considered merely an opportunistic infection. In this article, we focus on ten unanswered questions/topics in this field with the hope to stimulate discussion and research on these topics that would lead not only to a better understanding of the physiopathology of this disease but also to a better diagnosis and prognosis.     

Cell-mediated immunity in Cryptococcosis

Cell-mediated immune responses in patients who had recovered from cryptococcosis were compared to those of healthy subjects. Cryptococcal patients were mildly lymphopenic but showed no defect in percentage of thymus-derived lymphocytes. One-third had positive delayed skin test reactions to cryptococcal antigen. Their skin test reactivity to two commonly used noncryptococcal antigens was less intense than healthy control subjects. Strongly positive and specific lymphocyte transformation occurred in the presence of an extract of Cryptococcus neoformans (cryptococcin) in half of the patients. In contrast, few healthy subjects had positive transformation responses to cryptococcin. One patient who was followed sequentially through treatment of cryptococcal meningitis acquired strong cryptococcin reactivity during the course of treatment. Cellular immunologic response to cryptococcin identifies many subjects who have had C. neoformans exposure, and may be of value for assessing immunologic status of patients undergoing therapy. These studies also indicate that most patients with cryptococcosis have a degree of deficiency in cell-mediated response to fungal antigens even when a specific underlying disease process cannot be identified.     

肾移植与隐球菌感染

肾移植是目前开展最广泛的器官移植项目,由于免疫抑制剂及糖皮质激素的大量使用,肾移植术后的真菌感染已经成为一个重要医学课题。隐球菌病是器官移植患者常见的深部真菌感染,本文对肾移植术后发生隐球菌感染的易感因素、临床表现以及治疗和预防等方面做一论述。     

Cryptococcosis of the nasopharynx in mice and rats

Summary An attempt to infect the upper respiratory tract of mice and rats with various bacteria and fungi by intranasally instillation was performed. Cryptococcus neoformans was the only agent to invade the tissue. The infection was limited to the nasopharynx, a phenomenon which probably indicates the presence of a specific chemotaxis or receptor.Dedicated to Prof. W. Kaplan, DVM, MPH     

Induction of Protective Immunity Against Cryptococcosis

Cryptococcus neoformans, the predominant etiological agent of cryptococcosis, is an encapsulated fungal pathogen that can cause life-threatening infections of the central nervous system in immune compromised individuals resulting in high morbidity and mortality. Consequently, several studies have endeavored to understand those mechanisms that mediate resistance and susceptibility to Cryptococcus infection. In this review, we will examine the contributions of various components of the innate and adaptive immune response toward protection against cryptococcosis. We will focus our discussion on studies presented at the 8th International Conference on Cryptococcus and Cryptococcosis (ICCC). Remarkable progress has been made toward our understanding of host immunity and susceptibility to cryptococcal infection and the potential for vaccine development.     

Cryptococcosis in Patients with Hematologic Diseases

Purpose of Review

In this paper, we reviewed the epidemiology, diagnosis, and treatment of cryptococcosis in patients with hematologic malignancies. We reviewed all case series of cryptococcosis in different hematologic conditions, and looked at epidemiologic trends considering the new antineoplastic drugs introduced in the treatment of hematologic malignancies.

Recent Findings

Case series of cryptococcosis in patients with hematologic malignancies are scarce. We identified an increase in the proportion of cases of cryptococcosis occurring in patients with hematologic malignancies, and many case reports of cryptococcosis in patients receiving ibrutinib, a Bruton kinase inhibitor used in the treatment of chronic lymphoproliferative diseases.

Summary

Cryptococcosis is uncommon in patients with hematologic malignancies, but its occurrence may be associated with poor outcome. Hematologists should be aware of this complication if patients develop neurologic symptoms or present with pulmonary infiltrates that do not improve with antibiotics.

     

Isolated Skull Cryptococcosis in an Immunocompetent Patient

A 62-year-old immunocompetent rural woman who represents an isolated cryptococcal skull infection without systematic involvement is described. Diagnosis was based on positive India ink staining, positive histopathologic examination, and positive culture. Species identification was performed by growth on Sabouraud dextrose agar and CHROMagar medium and by sequencing of the intergenic and internal transcribed spacer regions of the rRNA genes. This case describes a rare presentation of Cryptococcus neoformans infection in a human immunodeficiency virus-negative patient. The lesions were significantly improved with treatment of daily oral itraconazole 400 mg. A maintenance therapy with a low-dose itraconazole was prescribed to warrant a clinical and mycological eradication. A two-year follow-up did not show any recurrence of infection.