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Chapter 21 : Cryptococcosis in Asia

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Abstract:

This chapter includes sections on aspects of the clinical epidemiology and features of cryptococcal infection particular to Asia and management practices and experience from Asia, especially where this differs in some respect from other regions. In Thailand, prior to the AIDS epidemic, was the most common cause of cryptococcosis and accounted for over half of all isolates that were recovered from human patients. The duration from onset of symptoms to diagnosis of cryptococcal meningitis in immunocompetent patients was longer than their predisposed counterparts. In immunocompetent patients, the cerebrospinal fluid (CSF) white cell count tended to be higher, and seizures, hydrocephalus, and shunt procedures were more frequent. Immunocompromised patients were more frequently found to have high fever and parenchymal lesions in cranial magnetic resonance imaging. A recent Cochrane review identified five randomized, controlled trials of antifungal therapy for primary prevention of cryptococcal disease in a total of 1,316 HIV-infected patients who mostly had CD4 cell counts less than 150 cells/μl. A study from Thailand showed that the use of temporary external lumbar drainage can be a reasonably safe and effective management strategy for intractable elevated CSF pressure not responding to serial lumbar puncture in HIV-infected patients with cryptococcal meningitis, even in relatively resource-limited settings.

Citation: Xu J, Manosuthi W, Banerjee U, Zhu L, Chen J, Kohno S, Izumikawa K, Chen Y, Sungkanuparph S, Harrison T, Fisher M. 2011. Cryptococcosis in Asia, p 287-297. In Heitman J, Kozel T, Kwon-Chung K, Perfect J, Casadevall A (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555816858.ch21

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Opportunistic Fungal Infections
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Fungal Infections
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Restriction Fragment Length Polymorphism
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Tables

Generic image for table
TABLE 1

Frequency of isolation of and from decaying wood in tree trunk hollows and bird droppings in various locations in India

Citation: Xu J, Manosuthi W, Banerjee U, Zhu L, Chen J, Kohno S, Izumikawa K, Chen Y, Sungkanuparph S, Harrison T, Fisher M. 2011. Cryptococcosis in Asia, p 287-297. In Heitman J, Kozel T, Kwon-Chung K, Perfect J, Casadevall A (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555816858.ch21
Generic image for table
TABLE 2

Demographic features and underlying diseases of 154 non-HIV patients with cryptococcal meningitis from Huashan Hospital, Shanghai

Citation: Xu J, Manosuthi W, Banerjee U, Zhu L, Chen J, Kohno S, Izumikawa K, Chen Y, Sungkanuparph S, Harrison T, Fisher M. 2011. Cryptococcosis in Asia, p 287-297. In Heitman J, Kozel T, Kwon-Chung K, Perfect J, Casadevall A (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555816858.ch21
Generic image for table
TABLE 3

Comparison between non-HIV-associated cryptococcal meningitis in predisposed hosts and healthy hosts in three series in Chinese populations

Citation: Xu J, Manosuthi W, Banerjee U, Zhu L, Chen J, Kohno S, Izumikawa K, Chen Y, Sungkanuparph S, Harrison T, Fisher M. 2011. Cryptococcosis in Asia, p 287-297. In Heitman J, Kozel T, Kwon-Chung K, Perfect J, Casadevall A (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555816858.ch21

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