Cryptococcal meningitis due to Cryptococcus neoformans genotype AFLP1/VNI in Iran: a review of the literature

Mycoses. 2015 Dec;58(12):689-93. doi: 10.1111/myc.12415. Epub 2015 Oct 7.

Abstract

Cryptococcal meningitis is the most important opportunistic fungal infection with a high mortality in HIV-patients in less developed regions. Here, we report a case of cryptococcal meningitis in a 49-year-old HIV-positive female due to Cryptococcus neoformans (serotype A, mating-type alpha, genotype AFLP1/VNI) in Sari, Iran. In vitro antifungal susceptibility tests showed MICs of isavuconazole (0.016 μg ml(-1) ), voriconazole (0.031 μg ml(-1) ), posaconazole (0.031 μg ml(-1) ), itraconazole (0.063 μg ml(-1) ), amphotericin B (0.125 μg ml(-1) ) and fluconazole (8 μg ml(-1) ). Despite immediate antifungal therapy, the patient died 4 days later due to respiratory failure. Cryptococcal infections have been infrequently reported from Iran and therefore we analysed all published cases of cryptococcosis in Iran since the first reported case from 1969.

Keywords: Cryptococcus species; HIV; Iran; molecular identification.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis*
  • AIDS-Related Opportunistic Infections / drug therapy
  • Adolescent
  • Adult
  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use
  • Child
  • Cryptococcus neoformans / classification
  • Cryptococcus neoformans / drug effects
  • Cryptococcus neoformans / genetics*
  • Drug Resistance, Fungal
  • Fatal Outcome
  • Female
  • Genotype
  • Humans
  • Iran / epidemiology
  • Male
  • Meningitis, Cryptococcal / diagnosis*
  • Meningitis, Cryptococcal / drug therapy
  • Meningitis, Cryptococcal / epidemiology*
  • Microbial Sensitivity Tests
  • Middle Aged
  • Mycological Typing Techniques
  • Respiratory Insufficiency / microbiology
  • Young Adult

Substances

  • Antifungal Agents

Associated data

  • GENBANK/JN939455
  • GENBANK/KP768192