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Difficulty diagnosing chronic cryptococcal meningitis in idiopathic CD4 lymphocytopenia.

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Title: Difficulty diagnosing chronic cryptococcal meningitis in idiopathic CD4 lymphocytopenia.
Authors: Sancesario, Giuseppe, Palmieri, Giampiero, Viola, Gemma, Fontana, Carla, Perfetti, Alessandra, Anemona, Lucia, Floris, Roberto, Marziali, Simone, Bernardi, Giorgio, Spagnoli, Luigi
Source: Neurological Sciences. Jun2011, Vol. 32 Issue 3, p519-524. 6p.
Subjects: Cryptococcosis, Meningitis, Lymphopenia, Cerebrospinal fluid, Cryptococcus neoformans, Macrophages, Inflammation, Hydrocephalus, Diagnosis
Abstract: 64-year-old man with idiopathic CD4 lymphocytopenia developed cognitive impairment and gait ataxia with isolated obstructive hydrocephalus, which was fatal. Cerebrospinal fluid showed mild pleocytosis, but the etiology was not revealed by extensive analysis. At autopsy, inflammatory cells, CD8 lymphocytes and abundant macrophages but not CD4 lymphocytes were infiltrating the meninges at the base of the brain. Electron microscopy demonstrated that inflammation was caused by Cryptococcus neoformans, which was localized exclusively within macrophages, where it grew with budding. Our study suggests that, in idiopathic CD4 lymphocytopenia, macrophages can efficiently phagocytize but inefficiently digest C. neoformans, thus representing a vehicle of chronic intracellular infection. [ABSTRACT FROM AUTHOR]
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Difficulty diagnosing chronic cryptococcal meningitis in idiopathic CD4 lymphocytopenia.
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  Data: <searchLink fieldCode="AR" term="%22Sancesario%2C+Giuseppe%22">Sancesario, Giuseppe</searchLink><br /><searchLink fieldCode="AR" term="%22Palmieri%2C+Giampiero%22">Palmieri, Giampiero</searchLink><br /><searchLink fieldCode="AR" term="%22Viola%2C+Gemma%22">Viola, Gemma</searchLink><br /><searchLink fieldCode="AR" term="%22Fontana%2C+Carla%22">Fontana, Carla</searchLink><br /><searchLink fieldCode="AR" term="%22Perfetti%2C+Alessandra%22">Perfetti, Alessandra</searchLink><br /><searchLink fieldCode="AR" term="%22Anemona%2C+Lucia%22">Anemona, Lucia</searchLink><br /><searchLink fieldCode="AR" term="%22Floris%2C+Roberto%22">Floris, Roberto</searchLink><br /><searchLink fieldCode="AR" term="%22Marziali%2C+Simone%22">Marziali, Simone</searchLink><br /><searchLink fieldCode="AR" term="%22Bernardi%2C+Giorgio%22">Bernardi, Giorgio</searchLink><br /><searchLink fieldCode="AR" term="%22Spagnoli%2C+Luigi%22">Spagnoli, Luigi</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Cryptococcosis%22">Cryptococcosis</searchLink><br /><searchLink fieldCode="DE" term="%22Meningitis%22">Meningitis</searchLink><br /><searchLink fieldCode="DE" term="%22Lymphopenia%22">Lymphopenia</searchLink><br /><searchLink fieldCode="DE" term="%22Cerebrospinal+fluid%22">Cerebrospinal fluid</searchLink><br /><searchLink fieldCode="DE" term="%22Cryptococcus+neoformans%22">Cryptococcus neoformans</searchLink><br /><searchLink fieldCode="DE" term="%22Macrophages%22">Macrophages</searchLink><br /><searchLink fieldCode="DE" term="%22Inflammation%22">Inflammation</searchLink><br /><searchLink fieldCode="DE" term="%22Hydrocephalus%22">Hydrocephalus</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnosis%22">Diagnosis</searchLink>
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  Data: 64-year-old man with idiopathic CD4 lymphocytopenia developed cognitive impairment and gait ataxia with isolated obstructive hydrocephalus, which was fatal. Cerebrospinal fluid showed mild pleocytosis, but the etiology was not revealed by extensive analysis. At autopsy, inflammatory cells, CD8 lymphocytes and abundant macrophages but not CD4 lymphocytes were infiltrating the meninges at the base of the brain. Electron microscopy demonstrated that inflammation was caused by Cryptococcus neoformans, which was localized exclusively within macrophages, where it grew with budding. Our study suggests that, in idiopathic CD4 lymphocytopenia, macrophages can efficiently phagocytize but inefficiently digest C. neoformans, thus representing a vehicle of chronic intracellular infection. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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