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Source: Carver PL. Invasive fungal infections. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=146073167. Accessed March 14, 2017
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Acquired by inhalation.
Stimulates minimal inflammatory response in tissue.
Polysaccharide capsule appears to allow resistance to host phagocytosis.
Four serotypes of C. neoformans
Cell-mediated immunity plays major role in host defense.
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C. neoformans found in soil, particularly in pigeon droppings.
Incidence has risen; increased numbers of immunocompromised patients, including those with malignancies, diabetes mellitus, chronic renal failure, and organ transplants receiving immunosuppressive agents.
No geographic area of endemic focus.
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CLINICAL PRESENTATION
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MEANS OF CONFIRMATION AND DIAGNOSIS
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DIAGNOSTIC PROCEDURES
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Lumbar puncture.
Elevated opening pressure.
CSF pleocytosis (usually lymphocytes)
Leukocytosis.
Decreased CSF glucose.
Elevated CSF protein.
Positive cryptococcal antigen.
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DIFFERENTIAL DIAGNOSIS
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Tuberculous meningitis.
Other fungal infection.
Neurosyphilis.
Lyme meningitis.
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TREATMENT: PHARMACOLOGIC THERAPY
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