ArticleCase reports in neurological medicine2016
Diagnostic Challenges of Cryptococcus neoformans in an Immunocompetent Individual Masquerading as Chronic Hydrocephalus.
Article in Case reports in neurological medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 15 citations in OpenAlex.
- Evaluation of a lateral flow immunochromatographic assay for detecting cryptococcal antigens in bronchoalveolar lavage fluid from HIV-negative patients with pulmonary cryptococcosis.Microbiology spectrum · 2026Article
- Article
- An Optimized In-House Protocol forJournal of fungi (Basel, Switzerland) · 2025Article
- [Cryptococcal meningitis associated with hydrocephalus in an immunocompetent patient].Anales del sistema sanitario de Navarra · 2024Article
- Disseminated cryptococcosis with gastrointestinal involvement and false-negative cryptococcal antigen testing due to postzone phenomenon: a case report and review of the literature.BMC infectious diseases · 2023Review
- False-negative cerebral spinal fluid cryptococcal antigen lateral flow assay due to postzone phenomenon in a patient with disseminated cryptococcal disease: a case report.The Journal of international medical research · 2023Article
- False-Negative Serum Cryptococcal Antigen Lateral Flow Immunoassay Result for a Patient with Disseminated Cryptococcal Disease.Infection and drug resistance · 2020Article
- False-negative result of serum cryptococcal antigen lateral flow assay in an HIV-infected patient with culture-proven cryptococcaemia.Medical mycology case reports · 2019Article
- How Environmental Fungi Cause a Range of Clinical Outcomes in Susceptible Hosts.Journal of molecular biology · 2019Review
- Article
- False-negative cryptococcal antigen test due to the postzone phenomenon.AIDS (London, England) · 2018Article
- Mechanisms of Pulmonary Escape and Dissemination by Cryptococcus neoformans.Journal of fungi (Basel, Switzerland) · 2018Review
- Capsule-Deficient Cryptococcal Meningitis: A Diagnostic Conundrum.Journal of global infectious diseasesArticle
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Cryptococcus neoformans can cause disseminated meningoencephalitis and evade immunosurveillance with expression of a major virulence factor, the polysaccharide capsule. Direct diagnostic assays often rely on the presence of the cryptococcal glucuronoxylomannan capsular antigen (CrAg) or visualization of the capsule. Strain specific phenotypic traits and environmental conditions influence differences in expression that can thereby compromise detection and timely diagnosis. Immunocompetent hosts may manifest clinical signs and symptoms indolently, often expanding the differential and delaying appropriate treatment and diagnosis. We describe a 63-year-old man who presented with a progressive four-year history of ambulatory dysfunction, headache, and communicating hydrocephalus. Serial lumbar punctures (LPs) revealed elevated protein (153-300 mg/dL), hypoglycorrhachia (19-47 mg/dL), lymphocytic pleocytosis (89-95% lymphocyte, WBC 67-303 mg/dL, and RBC 34-108 mg/dL), and normal opening pressure (13-16 cm H2O). Two different cerebrospinal fluid (CSF) CrAg assays were negative. A large volume CSF fungal culture grew unencapsulated C. neoformans. He was initiated on induction therapy with amphotericin B plus flucytosine and consolidation/maintenance therapy with flucytosine, but he died following discharge due to complications. Elevated levels of CSF Th1 cytokines and decreased IL6 may have affected the virulence and detection of the pathogen.
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