Fungal meningitis epidemiology and demographics: Difference between revisions
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*Cryptococcus meningitis occurs worldwide but it is highly prevalent in southeast Asia and southern and east Africa where the prevalence of [[HIV]] is high.<ref>Holmes CB, Losina E, Walensky RP, Yazdanpanah Y, Freedberg K (2003) Review of human immunodeficiency virus type 1-related opportunistic infections in Sub-Saharan Africa. Clin Infect Dis, 36, 652–662.</ref> | *Cryptococcus meningitis occurs worldwide but it is highly prevalent in southeast Asia and southern and east Africa where the prevalence of [[HIV]] is high.<ref>Holmes CB, Losina E, Walensky RP, Yazdanpanah Y, Freedberg K (2003) Review of human immunodeficiency virus type 1-related opportunistic infections in Sub-Saharan Africa. Clin Infect Dis, 36, 652–662.</ref> | ||
*It is a common opportunistic infection in patients with [[HIV]] and it is considered as an [[AIDS]] defining lesion. <ref>Chariyalertsak S, Sirisanthana T, Saengwonloey O, Nelson K (2001) Clinical presentation and risk behaviors of patients with acquired immunodeficiency syndrome in Thailand, 1994–1998: Regional variation and temporal trends. Clin Infect Dis, 32, 955–962.</ref> | *It is a common opportunistic infection in patients with [[HIV]] and it is considered as an [[AIDS]] defining lesion. <ref>Chariyalertsak S, Sirisanthana T, Saengwonloey O, Nelson K (2001) Clinical presentation and risk behaviors of patients with acquired immunodeficiency syndrome in Thailand, 1994–1998: Regional variation and temporal trends. Clin Infect Dis, 32, 955–962.</ref> | ||
Rates of cryptococcosis in non-HIV-infected individuals approach one case per 100,000 population and are comparable to incidence rates of meningococcal meningitis.<ref name="pmid8654513">{{cite journal| author=Hajjeh RA, Brandt ME, Pinner RW| title=Emergence of cryptococcal disease: epidemiologic perspectives 100 years after its discovery. | journal=Epidemiol Rev | year= 1995 | volume= 17 | issue= 2 | pages= 303-20 | pmid=8654513 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8654513 }} </ref> | |||
During the AIDS epidemic before highly active antiretroviral therapy (HAART) in the United States, cities such as Atlanta, Georgia were reporting annual rates of cryptococcosis as high as 66 cases per 1,000 persons with AIDS<ref name="pmid12627365">{{cite journal| author=Mirza SA, Phelan M, Rimland D, Graviss E, Hamill R, Brandt ME et al.| title=The changing epidemiology of cryptococcosis: an update from population-based active surveillance in 2 large metropolitan areas, 1992-2000. | journal=Clin Infect Dis | year= 2003 | volume= 36 | issue= 6 | pages= 789-94 | pmid=12627365 | doi=10.1086/368091 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12627365 }} </ref> | |||
During the era of HAART, this figure of disease has been reduced <ref name="pmid11125898">{{cite journal| author=van Elden LJ, Walenkamp AM, Lipovsky MM, Reiss P, Meis JF, de Marie S et al.| title=Declining number of patients with cryptococcosis in the Netherlands in the era of highly active antiretroviral therapy. | journal=AIDS | year= 2000 | volume= 14 | issue= 17 | pages= 2787-8 | pmid=11125898 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11125898 }} </ref> | |||
but not eliminated, and without HAART, the high infection rates persist and the natural history of untreated infection can still be traced.<ref name="pmid10930155">{{cite journal| author=Hakim JG, Gangaidzo IT, Heyderman RS, Mielke J, Mushangi E, Taziwa A et al.| title=Impact of HIV infection on meningitis in Harare, Zimbabwe: a prospective study of 406 predominantly adult patients. | journal=AIDS | year= 2000 | volume= 14 | issue= 10 | pages= 1401-7 | pmid=10930155 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10930155 }} </ref> | |||
By 2009, the Centers for Disease Control and Prevention estimated that worldwide, there are 1 million new cases of cryptococcosis per year with over 600,000 deaths, making it the most common invasive fungal infection in the world today.<ref name="pmid19182676">{{cite journal| author=Park BJ, Wannemuehler KA, Marston BJ, Govender N, Pappas PG, Chiller TM| title=Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS. | journal=AIDS | year= 2009 | volume= 23 | issue= 4 | pages= 525-30 | pmid=19182676 | doi=10.1097/QAD.0b013e328322ffac | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19182676 }} </ref> | |||
This species is predominantly found in clinical infections from Australia, Southeast Asia, and Central Africa; however, an infection outbreak with C. gattii more recently has emerged in Vancouver, Canada and the Pacific Northwestern United States<ref name="pmid15572442">{{cite journal| author=Kidd SE, Hagen F, Tscharke RL, Huynh M, Bartlett KH, Fyfe M et al.| title=A rare genotype of Cryptococcus gattii caused the cryptococcosis outbreak on Vancouver Island (British Columbia, Canada). | journal=Proc Natl Acad Sci U S A | year= 2004 | volume= 101 | issue= 49 | pages= 17258-63 | pmid=15572442 | doi=10.1073/pnas.0402981101 | pmc=535360 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15572442 }} </ref><ref name="pmid17370514">{{cite journal| author=MacDougall L, Kidd SE, Galanis E, Mak S, Leslie MJ, Cieslak PR et al.| title=Spread of Cryptococcus gattii in British Columbia, Canada, and detection in the Pacific Northwest, USA. | journal=Emerg Infect Dis | year= 2007 | volume= 13 | issue= 1 | pages= 42-50 | pmid=17370514 | doi=10.3201/eid1301.060827 | pmc=2725832 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17370514 }} </ref> | |||
Histoplasma meningitis | |||
incidence rates in 1976 ranged from 23.0 per million for histoplasmosis to 0.2 per million for blastomycosis.<ref name="pmid480580">{{cite journal| author=Fraser DW, Ward JI, Ajello L, Plikaytis BD| title=Aspergillosis and other systemic mycoses. The growing problem. | journal=JAMA | year= 1979 | volume= 242 | issue= 15 | pages= 1631-5 | pmid=480580 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=480580 }} </ref> | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby; Prince Tano Djan, BSc, MBChB [2]
Overview
While cryptococccus and candida infections occur worldwide, other fungal infections tend to cluster in specific geographical regions.[1][2] The most common cause of fungal meningitis is Cryptococcus neoformans.[3][4][2]
Epidemiology
Incidence and prevalence
There is an increasing trend of fungal meningitis. This has been attributed to the following: [2][5]
- Enlarging population of high-risk immunosuppressed patients
- More successful pharmacological immunosuppression and chemotherapies
- Increase in numbers of patients living with human immunodeficiency virus (HIV) infection and the acquired immunodeficiency syndrome (AIDS)
- Migration of susceptible persons into hyperendemic areas
- Aging of the population
Cryptococcus Meningitis
- It is the most common cause of fungal meningitis.[6][4][2]
- Cryptococcus meningitis occurs worldwide but it is highly prevalent in southeast Asia and southern and east Africa where the prevalence of HIV is high.[7]
- It is a common opportunistic infection in patients with HIV and it is considered as an AIDS defining lesion. [8]
Rates of cryptococcosis in non-HIV-infected individuals approach one case per 100,000 population and are comparable to incidence rates of meningococcal meningitis.[9]
During the AIDS epidemic before highly active antiretroviral therapy (HAART) in the United States, cities such as Atlanta, Georgia were reporting annual rates of cryptococcosis as high as 66 cases per 1,000 persons with AIDS[10]
During the era of HAART, this figure of disease has been reduced [11]
but not eliminated, and without HAART, the high infection rates persist and the natural history of untreated infection can still be traced.[12]
By 2009, the Centers for Disease Control and Prevention estimated that worldwide, there are 1 million new cases of cryptococcosis per year with over 600,000 deaths, making it the most common invasive fungal infection in the world today.[13]
This species is predominantly found in clinical infections from Australia, Southeast Asia, and Central Africa; however, an infection outbreak with C. gattii more recently has emerged in Vancouver, Canada and the Pacific Northwestern United States[14][15]
Histoplasma meningitis
incidence rates in 1976 ranged from 23.0 per million for histoplasmosis to 0.2 per million for blastomycosis.[5]
Coccidioido meningitis
- Coccidioidomycosis is only prevalent in the Western Hemisphere, especially in the southwestern United States and northwestern Mexico.
- The annual incidence of the disease is not known.
Age
Gender
Race
- Non-Caucasian race have a higher prediclection to developing fungal meningitis especially coccidioidal meningitis[16]
Developed Vs developing countries
Geographic Distribution of Endemic Fungi in The United States
- Blastomyces dermatiditis: Midwest and southeast of USA
- Coccidiodes immitis: Southwest of USA
- Histoplasma Capsulatum: Ohio, central Mississippi River Valley[17]
References
- ↑ Shankar SK, Mahadevan A, Sundaram C, Sarkar C, Chacko G, Lanjewar DN; et al. (2007). "Pathobiology of fungal infections of the central nervous system with special reference to the Indian scenario". Neurol India. 55 (3): 198–215. PMID 17921648.
- ↑ 2.0 2.1 2.2 2.3 Gottfredsson M, Perfect JR (2000). "Fungal meningitis". Semin Neurol. 20 (3): 307–22. doi:10.1055/s-2000-9394. PMID 11051295.
- ↑ Koroshetz WJ. Chapter 382. Chronic and Recurrent Meningitis. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, eds. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012.
- ↑ 4.0 4.1 Williamson PR, Jarvis JN, Panackal AA, Fisher MC, Molloy SF, Loyse A; et al. (2017). "Cryptococcal meningitis: epidemiology, immunology, diagnosis and therapy". Nat Rev Neurol. 13 (1): 13–24. doi:10.1038/nrneurol.2016.167. PMID 27886201.
- ↑ 5.0 5.1 Fraser DW, Ward JI, Ajello L, Plikaytis BD (1979). "Aspergillosis and other systemic mycoses. The growing problem". JAMA. 242 (15): 1631–5. PMID 480580.
- ↑ Koroshetz WJ. Chapter 382. Chronic and Recurrent Meningitis. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, eds. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012.
- ↑ Holmes CB, Losina E, Walensky RP, Yazdanpanah Y, Freedberg K (2003) Review of human immunodeficiency virus type 1-related opportunistic infections in Sub-Saharan Africa. Clin Infect Dis, 36, 652–662.
- ↑ Chariyalertsak S, Sirisanthana T, Saengwonloey O, Nelson K (2001) Clinical presentation and risk behaviors of patients with acquired immunodeficiency syndrome in Thailand, 1994–1998: Regional variation and temporal trends. Clin Infect Dis, 32, 955–962.
- ↑ Hajjeh RA, Brandt ME, Pinner RW (1995). "Emergence of cryptococcal disease: epidemiologic perspectives 100 years after its discovery". Epidemiol Rev. 17 (2): 303–20. PMID 8654513.
- ↑ Mirza SA, Phelan M, Rimland D, Graviss E, Hamill R, Brandt ME; et al. (2003). "The changing epidemiology of cryptococcosis: an update from population-based active surveillance in 2 large metropolitan areas, 1992-2000". Clin Infect Dis. 36 (6): 789–94. doi:10.1086/368091. PMID 12627365.
- ↑ van Elden LJ, Walenkamp AM, Lipovsky MM, Reiss P, Meis JF, de Marie S; et al. (2000). "Declining number of patients with cryptococcosis in the Netherlands in the era of highly active antiretroviral therapy". AIDS. 14 (17): 2787–8. PMID 11125898.
- ↑ Hakim JG, Gangaidzo IT, Heyderman RS, Mielke J, Mushangi E, Taziwa A; et al. (2000). "Impact of HIV infection on meningitis in Harare, Zimbabwe: a prospective study of 406 predominantly adult patients". AIDS. 14 (10): 1401–7. PMID 10930155.
- ↑ Park BJ, Wannemuehler KA, Marston BJ, Govender N, Pappas PG, Chiller TM (2009). "Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS". AIDS. 23 (4): 525–30. doi:10.1097/QAD.0b013e328322ffac. PMID 19182676.
- ↑ Kidd SE, Hagen F, Tscharke RL, Huynh M, Bartlett KH, Fyfe M; et al. (2004). "A rare genotype of Cryptococcus gattii caused the cryptococcosis outbreak on Vancouver Island (British Columbia, Canada)". Proc Natl Acad Sci U S A. 101 (49): 17258–63. doi:10.1073/pnas.0402981101. PMC 535360. PMID 15572442.
- ↑ MacDougall L, Kidd SE, Galanis E, Mak S, Leslie MJ, Cieslak PR; et al. (2007). "Spread of Cryptococcus gattii in British Columbia, Canada, and detection in the Pacific Northwest, USA". Emerg Infect Dis. 13 (1): 42–50. doi:10.3201/eid1301.060827. PMC 2725832. PMID 17370514.
- ↑ Bouza E, Dreyer JS, Hewitt WL, Meyer RD (1981). "Coccidioidal meningitis. An analysis of thirty-one cases and review of the literature". Medicine (Baltimore). 60 (3): 139–72. PMID 7231152.
- ↑ Koroshetz WJ. Chapter 382. Chronic and Recurrent Meningitis. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, eds. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012.