Cited by 1,213Fungal Infections and StudiesBacterial Infections and VaccinesAntifungal resistance and susceptibility

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Cryptococcosis in the era of AIDS--100 years after the discovery of Cryptococcus neoformans

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Mitchell, T G, Perfect, J R·1995·Clinical Microbiology Reviews

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Abstract

Although Cryptococcus neoformans and cryptococcosis have existed for several millennia, a century has passed since the discovery of this encapsulated yeast and its devastating disease. With the advent of the AIDS pandemic, cryptococcal meningitis has emerged as a leading cause of infectious morbidity and mortality and a frequently life-threatening opportunistic mycosis among patients with AIDS. Both basic and clinical research have accelerated in the 1990s, and this review attempts to highlight some of these advances. The discussion covers recent findings, current concepts, controversies, and unresolved issues related to the ecology and genetics of C. neoformans; the surface structure of the yeast; and the mechanisms of host defense. Regarding cell-mediated immunity, CD4+ T cells are crucial for successful resistance, but CD8+ T cells may also participate significantly in the cytokine-mediated activation of anticryptococcal effector cells. In addition to cell-mediated immunity, monoclonal antibodies to the major capsular polysaccharide, the glucuronoxylomannan, offer some protection in murine models of cryptococcosis. Clinical concepts are presented that relate to the distinctive features of cryptococcosis in patients with AIDS and the diagnosis, treatment, and prevention of cryptococcosis in AIDS patients.

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Dilated Virchow-Robin Spaces in Cryptococcal Meningitis Associated with AIDS
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Cryptococcal pulmonary infection in patients with AIDS: radiographic appearance.
Miller, W. T., Edelman, J. M., & Miller, W. T. (1990) · Radiology · doi:10.1148/radiology.175.3.2343121 · Cited by 83
Raised intracranial pressure and visual complications in AIDS patients with cryptococcal meningitis
Johnston, S. R. D., Corbett, E. L., Föster, O., et al. (1992) · Journal of Infection · doi:10.1016/0163-4453(92)92954-h · Cited by 83
Paradoxical role of capsule in murine bronchoalveolar macrophage-mediated killing of Cryptococcus neoformans.
Levitz, S. M., & DiBenedetto, D. J. (1989) · The Journal of Immunology · doi:10.4049/jimmunol.142.2.659 · Cited by 82

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Clinical Practice Guidelines for the Management of Cryptococcal Disease: 2010 Update by the Infectious Diseases Society of America
Perfect, J. R., Dismukes, W. E., Dromer, F., Goldman, D. L., Graybill, J. R., Hamill, R. J., Harrison, T. S., Larsen, R. A., Lortholary, O., Nguyen, M.-H., et al. (2010) · Clinical Infectious Diseases · doi:10.1086/649858 · Cited by 2,660
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Signal Transduction Cascades Regulating Fungal Development and Virulence
Lengeler, K. B., Davidson, R. C., D'souza, C., Harashima, T., Shen, W.-C., Wang, P., Pan, X., Waugh, M., & Heitman, J. (2000) · Microbiology and Molecular Biology Reviews · doi:10.1128/mmbr.64.4.746-785.2000 · Cited by 915
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Pfaller, M. A., & Diekema, D. J. (2010) · Critical Reviews in Microbiology · doi:10.3109/10408410903241444 · Cited by 901
Short-sequence DNA repeats in prokaryotic genomes
van Belkum, A., Scherer, S., van Alphen, L., & Verbrugh, H. (1998) · Microbiology and Molecular Biology Reviews · doi:10.1128/mmbr.62.2.275-293.1998 · Cited by 737
Calcineurin is required for virulence of Cryptococcus neoformans
Odom, A., Muir, S., Lim, E., Toffaletti, D. L., Perfect, J., & Heitman, J. (1997) · The EMBO Journal · doi:10.1093/emboj/16.10.2576 · Cited by 516
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Authors: Mitchell, T. G., & Perfect, J. R.
Affiliations: Duke Medical Center (US)
ORCID: Perfect, J R
Venue: Clinical Microbiology Reviews
Publisher: American Society for Microbiology
Published: 1995-10
Volume: 8
Issue: 4
Pages: 515-548
ISSN: 0893-8512 (ISSN-L)
1098-6618
DOI: 10.1128/cmr.8.4.515
PMC: PMC172874
OpenAlex: W2147038307
Cited by: 1,213
References: 494
Citations by year: 2026: 4 · 2025: 17 · 2024: 13 · 2023: 25 · 2022: 24 · 2021: 21 · 2020: 28 · 2019: 24 · 2018: 30 · 2017: 32 · 2016: 56 · 2015: 47 · 2014: 66 · 2013: 40 · 2012: 59
FWCI: 29.29
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: journals.asm.org/non-commercial-tdm-license (tdm)
Locations: Clinical Microbiology Reviews (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r01ai028836-08)
National Institute of Allergy and Infectious Diseases (AI 28836, AI28388, AI 25783, R01AI025783)
Topics: Health Sciences › Medicine › Infectious Diseases › Fungal Infections and Studies
Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Keywords: Cryptococcus neoformans, cryptococcosis, cryptococcal meningitis, AIDS, opportunistic fungal infection, cell-mediated immunity, CD4+ T cells, CD8+ T cells, glucuronoxylomannan, capsular polysaccharide, monoclonal antibodies, host defense, diagnosis, treatment, prevention
MeSH terms: Acquired Immunodeficiency Syndrome, Antifungal Agents, Cryptococcosis, Cryptococcus neoformans, Humans, Virulence, AIDS-Related Opportunistic Infections

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Cryptococcosis in the era of AIDS--100 years after the discovery of Cryptococcus neoformans

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