PMID- 23874010
OWN - NLM
STAT- MEDLINE
DCOM- 20140311
LR  - 20220321
IS  - 0065-7778 (Print)
IS  - 0065-7778 (Linking)
VI  - 124
DP  - 2013
TI  - Cryptococcal infections in non-HIV-infected patients.
PG  - 61-79
AB  - Infections due to Cryptococcus species occur globally and in a wide variety of 
      hosts, ranging from those who are severely immunosuppressed to those who have 
      phenotypically "normal" immune systems. Approximately 1 million cases of 
      cryptococcosis occur throughout the world, and is it estimated that there are 
      650,000 associated deaths annually. Most of these cases occur among patients with 
      advanced HIV disease, but a growing number occur among solid organ transplant 
      recipients and others receiving exogenous immunosuppression, patients with innate 
      and acquired immunodeficiency, and otherwise immunologically normal hosts. Much 
      of our recent knowledge is solely derived from clinical experience over the last 
      2 to 3 decades of cryptococcosis among HIV-infected patients. However, based on 
      recent observations, it is clear that there are substantial differences in the 
      epidemiology, clinical features, approaches to therapy, and outcome when 
      comparing HIV-infected to non-HIV-infected individuals who have cryptococcosis. 
      If one carefully examines cryptococcosis in the three largest subgroups of 
      patients based on host immune status, specifically, those with HIV, solid organ 
      transplant recipients, and those who are non-HIV, non-transplant (NHNT) infected 
      persons, then one can observe very different risks for infection, varied clinical 
      presentations, long-term complications, mortality, and approaches to therapy. 
      This article focuses on cryptococcosis in the non-HIV-infected patient, including 
      a brief review of ongoing events in the Pacific Northwest of the United States 
      and Canada relative to the outbreak of Cryptococcus gattii infections among a 
      largely immunologically normal population, and highlights some of the key 
      insights and questions which have emerged as a result of these important new 
      observations.
FAU - Pappas, Peter G
AU  - Pappas PG
AD  - Division of Infectious Diseases, University of Alabama at Birmingham, 1900 
      University Blvd, 229 THT, Birmingham, AL 35294-0006, USA. pappas@uab.edu
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Trans Am Clin Climatol Assoc
JT  - Transactions of the American Clinical and Climatological Association
JID - 7507559
RN  - 0 (Antifungal Agents)
RN  - 8VZV102JFY (Fluconazole)
SB  - IM
MH  - Adult
MH  - Antifungal Agents/therapeutic use
MH  - Cryptococcosis/drug therapy/*etiology
MH  - Cryptococcus gattii/classification
MH  - Disease Outbreaks
MH  - Female
MH  - Fluconazole/therapeutic use
MH  - Humans
MH  - Immunocompromised Host
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Risk Factors
MH  - Transplantation/*adverse effects
PMC - PMC3715903
COIS- Potential Conflicts of Interest: None disclosed.
EDAT- 2013/07/23 06:00
MHDA- 2014/03/13 06:00
PMCR- 2013/01/01
CRDT- 2013/07/23 06:00
PHST- 2013/07/23 06:00 [entrez]
PHST- 2013/07/23 06:00 [pubmed]
PHST- 2014/03/13 06:00 [medline]
PHST- 2013/01/01 00:00 [pmc-release]
PST - ppublish
SO  - Trans Am Clin Climatol Assoc. 2013;124:61-79.