title: Cryptococcal meningitis due to Cryptococcus neoformans genotype AFLP1/VNI in Iran: a review of the literature.
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.
authors.affiliation: Department of Medical Mycology and Parasitology/Invasive Fungi Research Center (IFRC), Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Badali
authors.affiliation: Department of Infectious Disease, Antimicrobial Resistance Research Center (ARRC), Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Shahriar
authors.initials: S
authors.lastname: Alian
authors.affiliation: Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Hamed
authors.initials: H
authors.lastname: Fakhim
authors.affiliation: Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Mahsa
authors.initials: M
authors.lastname: Falahatinejad
authors.affiliation: Department of Infectious Disease, Antimicrobial Resistance Research Center (ARRC), Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Moradi
authors.affiliation: Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Mehrnaz
authors.initials: M
authors.lastname: Mohammad Davoudi
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
authors.forename: Ferry
authors.initials: F
authors.lastname: Hagen
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.|Department of Medical Microbiology, Radboudumc, Nijmegen, The Netherlands.
authors.forename: Jacques F
authors.identifier: http://orcid.org/0000-0003-3253-6080
authors.initials: JF
authors.lastname: Meis
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy; D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D003455:Cryptococcus neoformans / Q000145:classification / Q000187:drug effects / Q000235:genetics*; D025141:Drug Resistance, Fungal; D017809:Fatal Outcome; D005260:Female; D005838:Genotype; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D016919:Meningitis, Cryptococcal / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016533:Mycological Typing Techniques; D012131:Respiratory Insufficiency / Q000382:microbiology; D055815:Young Adult
chemical_list: D000935:Antifungal Agents
keywords: Cryptococcus species; HIV; Iran; molecular identification