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Cryptococcosis

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Fungal Infections of the Central Nervous System

Abstract

Human fungal diseases now constitute a significant global health problem particularly in resource-poor countries with the emergence of human immunodeficiency virus ( HIV)/acquired immunodeficiency syndrome (AIDS), rapid increase in successful solid organ transplantations, and the expanding armamentarium of immunosuppressive drugs for treatment of cancers and autoimmune and rheumatological diseases. There is an urgent need for better diagnostic tools and a wider array of therapies to treat these lethal infections. Cryptococcal infection is one of the most common opportunistic infections. This “sugar-coated” yeast is a unique model of eukaryotic virulence. The pathology and immunopathogenic mechanism of Cryptococcus species are the most studied, and have helped in enhancing our understanding of fungal pathogenesis in general, developing robust diagnostic tests, as well as standardizing treatment modalities. However, there remain several unanswered questions as to how these pathogens cause disease within the central nervous system. Unravelling answers to these questions will provide new insights into organ-specific fungal pathogenesis and will help develop effective treatment reducing morbidity and mortality.

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Abbreviations

AIDS:

Acquired immunodeficiency syndrome

ART:

Antiretroviral therapy

BBB:

Blood-brain barrier

CM:

Cryptococcal meningitis

CNS:

Central nervous system

CSF:

Cerebrospinal fluid

DC:

Dendritic cell

EFA:

Early fungicidal activity

HAART:

Highly active antiretroviral therapy

GalXM:

Galactoxylomannan

GXM:

Glucuronoxylomannan

HIV:

Human immunodeficiency virus

IL:

Interleukin

INOS:

Inducible nitric oxide synthase

IRD:

Immune restoration disease

IRIS:

Immune reconstitution inflammatory syndrome

MP:

Mannoprotein

MRI:

Magnetic resonance imaging

TNF:

Tumor necrosis factor

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Authors and Affiliations

  1. Department of Neuropathology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India

    Anita Mahadevan & Shankar Krishna Susarla

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  1. Anita Mahadevan
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  2. Shankar Krishna Susarla
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Editors and Affiliations

  1. Department of Neurosurgery, Aydın Adnan Menderes University, School of Medicine, Aydın, Turkey

    Mehmet Turgut

  2. Department of Pathology, Basavatarakam Indo-American Hospital & Research Institute, Hyderabad, Telangana, India

    Sundaram Challa

  3. Department of Neurosurgery, Avicenne Military Hospital, Mohammed V University in Rabat, Marrakech, Morocco

    Ali Akhaddar

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Mahadevan, A., Susarla, S.K. (2019). Cryptococcosis. In: Turgut, M., Challa, S., Akhaddar, A. (eds) Fungal Infections of the Central Nervous System. Springer, Cham. https://doi.org/10.1007/978-3-030-06088-6_12

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