Cryptococcal Meningitis

Note: the content in these publications is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Novel Treatment of Cryptococcal Meningitis via Neurapheresis Therapy

Smilnak et al.
The Journal of Infectious Diseases, Volume 218, Issue 7, 24 August 2018, Pages 1147–1154, June 5 2017

Cryptococcal meningitis (CM) has emerged as the most common life-threatening fungal meningitis worldwide. Current management involves a sequential, longitudinal regimen of antifungals; despite a significant improvement in survival compared with uniform mortality without treatment, this drug paradigm has not led to a consistent cure. Neurapheresis therapy, extracorporeal filtration of yeasts from cerebrospinal fluid (CSF) in infected hosts, is presented here as a novel, one-time therapy for CM. In vitro filtration of CSF through this platform yielded a 5-log reduction in concentration of the yeast and a 1-log reduction in its polysaccharide antigen over 24 hours…

Prevalence, healthcare resource utilization and overall burden of fungal meningitis in the United States

Charalambous et al.
Journal of Medical Microbiology 2018;67:215–227 DOI 10.1099/jmm.0.000656 February 2018

Previous epidemiological and cost studies of fungal meningitis have largely focused on single pathogens, leading to a poor understanding of the disease in general. We studied the largest and most diverse group of fungal meningitis patients to date, over the longest follow-up period, to examine the broad impact on resource utilization within the United States.

In Vitro Characterization of the Neurapheresis™ System for the Treatment of Cryptococcal Meningitis

Duke University Medical Center/Minnetronix Neuro
ID Week 2017 – October 4-8, 2017 – San Diego, CA

Cryptococcal Meningitis is caused by Cryptococcus neoformans and is the most common cause of fungal meningitis in adults. Treatment for Cryptococcal Meningitis is based on an induction, consolidation, and maintenance approach with antifungals, but is associated with continued high morbidity and mortality. A catheter-based extracorporeal filtration system (Neurapheresis™ Therapy) for the filtration of infected CSF is a potential alternate or adjunctive intervention. This poster, produced with Duke University describes the in vitro characterization of Neurapheresis™ Therapy as an alternative mechanical intervention for filtration of C. neoformans cells, polysaccharide antigen, and inflammatory mediators from infected CSF.

Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under award number R41AI120304 (100% support, $1,711,835)

A Novel Therapeutic Approach for Cryptococcal Meningitis

Duke University School of Medicine/Minnetronix Neuro
ID Week 2016 – October 26-30, 2016 – New Orleans, LA

Cryptococcal meningitis (CM) is a devastating opportunistic infection that primarily presents in immunocompromised patients. CM is caused when Cryptococcus neoformans, a basidiomycete fungal pathogen, invades the central nervous system (CNS) and circulates within cerebospinal fluid (CSF) around the brain and spinal cord in the subarachnoid space. Current treatment guidelines include two weeks of continuous intravenous administration of amphotericin B and flucytosine, and maintaining a fungicidal regimen for six months. The single most important factor impacting survival has been shown to be rapid reduction of C. neoformans organisms in CSF during the first two weeks of infection. This poster describes an experimental filtration system, demonstrating a 1-2 log reduction in CSF organism burden using an infected rabbit model of CM.

Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under award number R41AI120304 (100% support, $1,711,835)

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