ArticlePloS one2014
Treatment and outcomes among patients with Cryptococcus gattii infections in the United States Pacific Northwest.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Cryptococcosis-a systematic review to inform the World Health Organization Fungal Priority Pathogens List.Medical mycology · 2024Pooled it
- Clinical-imaging and therapeutic evaluation of nodule-mass pulmonary cryptococcosis and pneumonia-type pulmonary cryptococcosis.BMC pulmonary medicine · 2025Article
- Predictors of Cryptococcus gattii Clinical Presentation and Outcome: An International Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Case Report: A Pulmonary Cryptococcosis Presenting as Interstitial Pneumonia in a Patient of IgA Nephropathy.Infection and drug resistance · 2025Article
- Review
- An immunoinformatics and extensive molecular dynamics study to develop a polyvalent multi-epitope vaccine against cryptococcosis.PloS one · 2024Article
- Cryptococcal Meningitis: Differences between Patients with and without HIV-Infection.Pathogens (Basel, Switzerland) · 2023Article
- What's New inJournal of fungi (Basel, Switzerland) · 2022Review
- Comparison of CT findings and histopathological characteristics of pulmonary cryptococcosis in immunocompetent and immunocompromised patients.Scientific reports · 2022Article
- Article
- MSG07: An International Cohort Study Comparing Epidemiology and Outcomes of Patients With Cryptococcus neoformans or Cryptococcus gattii Infections.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Successful Isavuconazole Salvage Therapy for a Cryptococcus deuterogattii (AFLP6/VGII) Disseminated Infection in a European Immunocompetent Patient.Mycopathologia · 2021Article
- Intra-cavitary pulmonary cryptococcoma in poorly controlled diabetes mellitus.Medical mycology case reports · 2020Article
- Clinical and Radiological Features of Patients With Pulmonary Cryptococcosis in a Hospital of North China.Cureus · 2020Article
- Cryptococcus neoformans and Cryptococcus gattii clinical isolates from Thailand display diverse phenotypic interactions with macrophages.Virulence · 2019Article
- Improved potency and reduced toxicity of the antifungal peptoid AEC5 through submonomer modification.Bioorganic & medicinal chemistry letters · 2018Article
- Article
- Cryptococcosis.Infectious disease clinics of North America · 2016Review
- Fluconazole Susceptibility in Cryptococcus gattii Is Dependent on the ABC Transporter Pdr11.Antimicrobial agents and chemotherapy · 2015Article
- Cryptococcal Meningitis: Diagnosis and Management Update.Current tropical medicine reports · 2015Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCryptococcus gattii is a fungal pathogen causing an emerging outbreak in the United States Pacific Northwest (PNW). Treatment guidelines for cryptococcosis are primarily based on data from C. neoformans infections; applicability to PNW C. gattii infection is unknown. We evaluated the relationship between initial antifungal treatment and outcomes for PNW C. gattii patients.
methodsCases were defined as culture-confirmed invasive C. gattii infections among residents of Oregon and Washington States during 2004-2011. Clinical data were abstracted from medical records through one year of follow-up. Recommended initial treatment for central nervous system (CNS), bloodstream, and severe pulmonary infections is amphotericin B and 5-flucytosine; for non-severe pulmonary infections, recommended initial treatment is fluconazole. Alternative initial treatment was defined as any other initial antifungal treatment.
resultsSeventy patients survived to diagnosis; 50 (71%) received the recommended initial treatment and 20 (29%) received an alternative. Fewer patients with pulmonary infections [21 (64%)] than CNS infections [25 (83%)] received the recommended initial treatment (p = 0.07). Among patients with pulmonary infections, those with severe infections received the recommended initial treatment less often than those with non-severe infections (11% vs. 83%, p<0.0001). Eight patients with severe pulmonary infections received alternative initial treatments; three died. Four patients with non-severe pulmonary infections received alternative initial treatments; two died. There was a trend towards increased three-month mortality among patients receiving alternative vs. recommended initial treatment (30% vs. 14%, p = 0.12), driven primarily by increased mortality among patients with pulmonary disease receiving alternative vs. recommended initial treatment (42% vs. 10%, p = 0.07).
conclusionsC. gattii patients with pulmonary infections--especially severe infections--may be less likely to receive recommended treatment than those with CNS infections; alternative treatment may be associated with increased mortality. Reasons for receipt of alternative treatment among C. gattii patients in this area should be investigated, and clinician awareness of recommended treatment reinforced.
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