title: Immune dysfunction in HIV-seronegative, Cryptococcus gattii meningitis.
abstract: The pathophysiology of meningitis caused by Cryptococcus gattii in apparently immunocompetent individuals remains unclear. We measured multiple cytokines in CSF from a HIV-seronegative, apparently immunocompetent, Thai patient with C. gattii meningitis, over the first 2 weeks of antifungal therapy. Levels of proinflammatory IFN-gamma, TNF-alpha, and IL-6 were very low compared to patients with HIV-related Cryptococcus neoformans meningitis and of IL-10 very high. While patients with C. gattii meningitis may be a heterogeneous group, these data suggest in this case a maladapted immune response to cryptococcal exposure had allowed progression to clinical cryptococcal disease.
authors.affiliation: Centre for Infection, St. George's University of London, Cranmer Terrace, London SW17 ORE, UK.
authors.forename: Annemarie E
authors.initials: AE
authors.lastname: Brouwer
authors.forename: Asna A
authors.initials: AA
authors.lastname: Siddiqui
authors.forename: Maartje I
authors.initials: MI
authors.lastname: Kester
authors.forename: Kim C E
authors.initials: KC
authors.lastname: Sigaloff
authors.forename: Adul
authors.initials: A
authors.lastname: Rajanuwong
authors.forename: Saran
authors.initials: S
authors.lastname: Wannapasni
authors.forename: Wirongrong
authors.initials: W
authors.lastname: Chierakul
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Harrison
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D002555:Cerebrospinal Fluid / Q000276:immunology; D003454:Cryptococcus / Q000302:isolation & purification*; D016207:Cytokines / Q000032:analysis*; D018023:HIV Seronegativity; D006801:Humans; D008297:Male; D008581:Meningitis / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology*; D016919:Meningitis, Cryptococcal / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology*
chemical_list: D000935:Antifungal Agents; D016207:Cytokines