Dexamethasone in Cryptococcus gattii central nervous system infection.

Clinical outcomes were reviewed for 4 patients with Cryptococcus gattii central nervous system infection who received dexamethasone for the treatment of persisting mental status abnormalities and focal lesions on brain scan despite culture-negative cerebrospinal fluid and the management of intracranial pressure. Favorable clinical responses were observed in 3 patients. Although corticosteroids are not recommended for the treatment of cryptococcal meningitis, these observations suggest that dexamethasone should be further evaluated in this subset of patients.

[1]  S. Levitz,et al.  Direct Inhibition of T-Cell Responses by the Cryptococcus Capsular Polysaccharide Glucuronoxylomannan , 2006, PLoS pathogens.

[2]  G. Klintmalm,et al.  An immune reconstitution syndrome-like illness associated with Cryptococcus neoformans infection in organ transplant recipients. , 2005, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[3]  S. Shelburne,et al.  The role of immune reconstitution inflammatory syndrome in AIDS-related Cryptococcus neoformans disease in the era of highly active antiretroviral therapy. , 2005, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[4]  T. Boekhout,et al.  A rare genotype of Cryptococcus gattii caused the cryptococcosis outbreak on Vancouver Island (British Columbia, Canada). , 2004, Proceedings of the National Academy of Sciences of the United States of America.

[5]  F. Coenjaerts,et al.  Dexamethasone downregulates Cryptococcus neoformans-induced vascular endothelial growth factor production: a role for corticosteroids in cryptococcal meningitis? , 2004, Journal of acquired immune deficiency syndromes.

[6]  D. Gordon,et al.  Paradoxical inflammatory reaction during treatment of Cryptococcus neoformans var. gattii meningitis in an HIV-seronegative woman. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[7]  P. Mwinzi,et al.  Intrathecal production and secretion of vascular endothelial growth factor during Cryptococcal Meningitis. , 2004, The Journal of infectious diseases.

[8]  J. McBride,et al.  Steroid responsive late deterioration in Cryptococcus neoformans variety gattii meningitis , 2004, Neurology.

[9]  K. Arimura,et al.  Expression of vascular endothelial growth factor in tuberculous meningitis , 2001, Journal of the Neurological Sciences.

[10]  K. Byth,et al.  Epidemiology and host- and variety-dependent characteristics of infection due to Cryptococcus neoformans in Australia and New Zealand. Australasian Cryptococcal Study Group. , 2000, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[11]  J. Perfect,et al.  Practice guidelines for the management of cryptococcal disease. Infectious Diseases Society of America. , 2000, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[12]  M. Saag,et al.  Diagnosis and Management of Increased Intracranial Pressure in Patients with AIDS and Cryptococcal Meningitis , 2000 .

[13]  N. van Bruggen,et al.  VEGF antagonism reduces edema formation and tissue damage after ischemia/reperfusion injury in the mouse brain. , 1999, The Journal of clinical investigation.

[14]  D. Warrell,et al.  The effect of corticosteroids on visual loss in Cryptococcus neoformans var. gattii meningitis. , 1997, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[15]  T. Sorrell,et al.  Cryptococcal disease of the CNS in immunocompetent hosts: influence of cryptococcal variety on clinical manifestations and outcome. , 1995, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[16]  K. Kwon-Chung,et al.  Epidemiologic differences between the two varieties of Cryptococcus neoformans. , 1984, American journal of epidemiology.

[17]  A. Forrestel,et al.  CRYPTOCOCCOSIS , 1982, The Lancet.