ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
Spinal Arachnoiditis as a Complication of Cryptococcal Meningoencephalitis in Non-HIV Previously Healthy Adults.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Cerebrospinal Fluid sCD27 as a Biomarker of Neuroinflammatory Disease: A Systematic Review and Meta-Analysis.Journal of neurochemistry · 2026Pooled it
- Pooled it
- Cryptococcal Meningoencephalitis in Phenotypically Normal Patients.Pathogens (Basel, Switzerland) · 2023Review
- Cryptococcal Meningitis in Young, Immunocompetent Patients: A Single-Center Retrospective Case Series and Review of the Literature.Open forum infectious diseases · 2023Review
- Hydrocephalus, massive myelitis, and adhesive arachnoiditis: full neuroaxis involvement by neurocryptococcosis.Arquivos de neuro-psiquiatria · 2023Article
- Cryptococcal Immune Reconstitution Inflammatory Syndrome: From Clinical Studies to Animal Experiments.Microorganisms · 2022Review
- Spinal Arachnoiditis in Patients with Coccidioidomycosis Meningitis-Analysis of Clinical and Imaging Features.Journal of fungi (Basel, Switzerland) · 2022Article
- Case report: a special case of cryptococcal infection-related inflammatory syndrome in a non-HIV infected and non-transplant patient.BMC neurology · 2022Article
- Article
- CNS cryptococcosis presenting with cerebellar stroke and spinal arachnoiditis.BMJ case reports · 2022Article
- Immunological Predictors of Post Infectious Inflammatory Response Syndrome in HIV-Negative Immunocompetent Cryptococcal Meningitis.Frontiers in immunology · 2022Article
- Treatment recommendations for non-HIV associated cryptococcal meningoencephalitis including management of post-infectious inflammatory response syndrome.Frontiers in neurology · 2022Review
- Spinal arachnoiditis and syringomyelia: Review of literature with emphasis on postinfectious inflammation and treatment.Surgical neurology international · 2022Review
- Outcomes in Previously Healthy Cryptococcal Meningoencephalitis Patients Treated With Pulse Taper Corticosteroids for Post-infectious Inflammatory Syndrome.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Quality of life of HIV-negative, previously healthy individuals following cryptococcal meningoencephalitis.Scientific reports · 2021Article
- Case Report: Paradoxical Inflammatory Response Syndrome in a Previously Healthy, HIV-Negative, Pediatric Patient WithFrontiers in pediatrics · 2021Article
- Cryptococcal meningitis presenting as anterior spinal cord syndrome with accessory nerve palsy in immunocompetent patient: A case report.Surgical neurology international · 2021Article
- Spinal arachnoiditis followed by intrathecal tigecycline therapy for central nervous system infection by extremely drug-resistantThe Journal of international medical research · 2020Article
- A Multicenter, Longitudinal Cohort Study of Cryptococcosis in Human Immunodeficiency Virus-negative People in the United States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Clinical Aspects of Immune Damage in Cryptococcosis.Current fungal infection reports · 2019Article
Corrections and comments
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Authors and funding
14 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundCryptococcus can cause meningoencephalitis (CM) among previously healthy non-HIV adults. Spinal arachnoiditis is under-recognized, since diagnosis is difficult with concomitant central nervous system (CNS) pathology.
methodsWe describe 6 cases of spinal arachnoiditis among 26 consecutively recruited CM patients with normal CD4 counts who achieved microbiologic control. We performed detailed neurological exams, cerebrospinal fluid (CSF) immunophenotyping and biomarker analysis before and after adjunctive immunomodulatory intervention with high dose pulse corticosteroids, affording causal inference into pathophysiology.
resultsAll 6 exhibited severe lower motor neuron involvement in addition to cognitive changes and gait disturbances from meningoencephalitis. Spinal involvement was associated with asymmetric weakness and urinary retention. Diagnostic specificity was improved by MRI imaging which demonstrated lumbar spinal nerve root enhancement and clumping or lesions. Despite negative fungal cultures, CSF inflammatory biomarkers, sCD27 and sCD21, as well as the neuronal damage biomarker, neurofilament light chain (NFL), were elevated compared to healthy donor (HD) controls. Elevations in these biomarkers were associated with clinical symptoms and showed improvement with adjunctive high dose pulse corticosteroids.
conclusionsThese data suggest that a post-infectious spinal arachnoiditis is an important complication of CM in previously healthy individuals, requiring heightened clinician awareness. Despite microbiological control, this syndrome causes significant pathology likely due to increased inflammation and may be amenable to suppressive therapeutics.
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