Scandinavian Journal of Infectious Diseases最新文献

{"title":"Association of Raoultella bacteremia with diseases of the biliary tract.","authors":"Kerry O Cleveland, Shirin A Mazumder, Michael S Gelfand","doi":"10.3109/00365548.2014.896032","DOIUrl":"https://doi.org/10.3109/00365548.2014.896032","url":null,"abstract":"The report by De Jong et al. [1] of several cases of Raoultella bacteremia associated with biliary disease was interesting to us as we recently encountered a similar patient. A 66-y-old woman with unresectable pancreatic cancer was admitted with nausea, emesis, increasing weakness, and neutropenic fever several days after beginning her second cycle of FOLFOX chemotherapy (folinic acid, fl uorouracil, and oxaliplatin). There was no history of fl ushing or recent fi sh ingestion. Other than a temperature of 39 ° C, her physical examination (including abdominal examination) was unremarkable. Her absolute neutrophil count was 150 cells/mm 3 . An abdominal computed tomogram did not reveal abscess or air. Empiric antibiotic therapy with piperacillin – tazobactam 3.375 g intravenously every 6 h was begun. Blood cultures obtained at admission grew Raoultella ornithinolytica and Escherichia coli. Subsequent blood cultures demonstrated clearing of both organisms. Despite this apparent response to treatment of her infection, her condition continued to deteriorate and her family opted for palliative care. She died 18 days after admission. While reviewing materials related to Raoultella spp. we noted many of the same materials referenced by De Jong et al. [1]. Additionally we noted several other reported cases of bacteremia due to Raoultella spp. These are summarized in Table I [2 – 5]. As described by De Jong et al. [1], many of these cases are associated with biliary disease. Also striking to us is the possible association with malignant processes that may have involvement of the biliary and/ or pancreatic system. Bile acids have previously been shown to be tumor promoters, and increased ornithine decarboxylase activity has been noted with rapid cell proliferation [6]. The importance of the biliary system and any impact of neoplastic processes on that system and its suitability as a milieu for growth of Raoultella spp. remain to be seen.","PeriodicalId":21541,"journal":{"name":"Scandinavian Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365548.2014.896032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32216936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for nasopharyngeal carriage of Streptococcus pneumoniae and effects of a hygiene intervention: repeated cross-sectional cohort study at day care centres.","authors":"Thorolfur Gudnason,&nbsp;Birgir Hrafnkelsson,&nbsp;Brynja Laxdal,&nbsp;Karl G Kristinsson","doi":"10.3109/00365548.2014.901553","DOIUrl":"https://doi.org/10.3109/00365548.2014.901553","url":null,"abstract":"<p><strong>Background: </strong>Day care attendance and antibiotic consumption are major risk factors for carriage of antibiotic-susceptible and non-susceptible pneumococci. We describe the nasopharyngeal carriage of antibiotic-susceptible and non-susceptible pneumococci among children at day care centres (DCCs), analyse the association of potential risk factors with carriage, and examine the effects of a hygiene intervention on carriage.</p><p><strong>Methods: </strong>Thirty DCCs in 2 communities were included in a cohort intervention trial. Nasopharyngeal cultures and information on the children were obtained every 6 months. The study lasted 2.5 y and the hygiene intervention was introduced at half of the DCCs during the last 1.5 y of the study. The results were analysed using a mixed effects logistic regression model.</p><p><strong>Results: </strong>A total of 5663 cultures were obtained from 2399 children, of which 55.6% grew pneumococci. Of the pneumococci, 27.9% were penicillin-non-susceptible (PNSP). The hygiene intervention was associated with a decreased risk of pneumococcal carriage, but this did not reach statistical significance for PNSP carriage. Pneumococcal and PNSP carriage was negatively associated with age, varied significantly between DCCs, and was positively associated with the number of preceding colds. Individual antibiotic use (mainly penicillin/amoxicillin) at the time of sampling and/or during the preceding month was associated with a decreased risk of pneumococcal and PNSP carriage. Individual use of cephalosporins was associated with an increased risk of carriage of penicillin and TMP-SMX-non-susceptible pneumococci.</p><p><strong>Conclusion: </strong>The hygiene intervention at the DCCs reduced the risk of pneumococcal carriage and the individual use of antibiotics was found to affect carriage in a complex manner.</p>","PeriodicalId":21541,"journal":{"name":"Scandinavian Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365548.2014.901553","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32299664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibacterial use in the Faroe Islands, Iceland, and Denmark 1999-2011.","authors":"Marita Debess Magnussen,&nbsp;Thorolfur Gudnason,&nbsp;Ulrich Stab Jensen,&nbsp;Niels Frimodt-Møller,&nbsp;Karl G Kristinsson","doi":"10.3109/00365548.2014.902538","DOIUrl":"https://doi.org/10.3109/00365548.2014.902538","url":null,"abstract":"<p><strong>Background: </strong>The Faroe Islands, Iceland, and Denmark are neighbouring Nordic countries with great ethnic, cultural, and political similarities and are relatively homogeneous. Important information about prescribing practices can be obtained by comparing the antibacterial use in these countries. The objective was to describe, compare, and analyse the use of systemic antibacterial agents in these countries during the y 1999-2011.</p><p><strong>Methods: </strong>Data were obtained from the Faroe Islands, Iceland, and Denmark on systemic antibacterial use and expressed in defined daily dosages (DDD). Prescription data were also obtained for specific age groups.</p><p><strong>Results: </strong>The total antibacterial use for the y 1999-2011 varied markedly between the 3 countries, with a mean use of 21.8 DDD/1000 inhabitants/day (DID) in Iceland, 17.7 in the Faroe Islands, and 16.3 in Denmark. The total use remained fairly constant over the years in the Faroe Islands and Iceland, whereas in Denmark it increased gradually from 13.5 DID in 1999 to 19.5 DID in 2011. The higher use in Iceland can be explained by much higher consumption of tetracyclines. There was also considerable variation in the use of individual penicillins and macrolides between the countries.</p><p><strong>Conclusions: </strong>Despite the great ethnic and cultural similarities of these 3 countries, we found marked differences in total antibacterial use and important differences in the use of individual antibacterials.</p>","PeriodicalId":21541,"journal":{"name":"Scandinavian Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365548.2014.902538","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32347012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SCCmec types and pvl gene in methicillin-resistant Staphylococcus aureus strains from children hospitalized in a tertiary care hospital in Mexico.","authors":"Eunice Mireya Borbón-Esquer,&nbsp;Alberto Villaseñor-Sierra,&nbsp;Erika Martínez-López,&nbsp;Juan José Jáuregui-Lomeli,&nbsp;Rosa Villaseñor-Martínez,&nbsp;Mariana Del Rocío Ruiz-Briseño","doi":"10.3109/00365548.2014.912349","DOIUrl":"https://doi.org/10.3109/00365548.2014.912349","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to determine the prevalence, SCCmec types, presence of the Panton-Valentine leukocidin (PVL) gene, and susceptibility to antibiotics of methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from hospitalized children.</p><p><strong>Methods: </strong>From August 2009 to September 2011, 291 S. aureus strains were isolated from normally sterile body sites, of which 190 (65%) were MRSA. One hundred and two of the MRSA strains were genetically evaluated. SCCmec genotypes were identified by M-PCR and the PVL gene (pvl) by end-point PCR. Resistance to erythromycin, rifampicin, clindamycin, and trimethoprim-sulfamethoxazole (SXT) was assessed by Kirby-Bauer disk diffusion method in accordance with the Clinical and Laboratory Standards Institute guidelines of 2012.</p><p><strong>Results: </strong>Of the 102 strains evaluated, 97 (95%) were SCCmec type II, 5 (5%) were SCCmec type IVa, and all (100%) were pvl-negative. Resistance to erythromycin, clindamycin, rifampicin, and SXT was 97%, 95%, 0%, and 0%, respectively.</p><p><strong>Conclusions: </strong>The prevalence of hospital-acquired MRSA was high. SCCmec type II was predominant and the pvl gene appeared not to play any role in the virulence of the MRSA strains from hospitalized children.</p>","PeriodicalId":21541,"journal":{"name":"Scandinavian Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365548.2014.912349","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32346916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships between the varied ciliated respiratory epithelium abnormalities and severity of Mycoplasma pneumoniae pneumonia.","authors":"Wujun Jiang,&nbsp;Lulu Qian,&nbsp;Hui Liang,&nbsp;Man Tian,&nbsp;Feng Liu,&nbsp;Deyu Zhao","doi":"10.3109/00365548.2014.885658","DOIUrl":"https://doi.org/10.3109/00365548.2014.885658","url":null,"abstract":"<p><strong>Background: </strong>The pathogenesis of Mycoplasma pneumoniae infection involves cytoadherence of M. pneumoniae to the ciliated respiratory epithelium (CRE), followed by CRE injury caused by the M. pneumoniae. However, whether CRE abnormalities are related to the severity of M. pneumoniae pneumonia (MP) remains to be determined.</p><p><strong>Methods: </strong>Thirty-eight patients with MP and 8 controls who underwent fiber-optic bronchoscopy with bronchial biopsy were included in this study. Patients with MP were divided into 2 groups: a mild disease group (12 patients) and a severe disease group (26 patients). The clinical features, laboratory findings, chest radiographic findings, and CRE abnormalities were characterized.</p><p><strong>Results: </strong>Patients with severe pneumonia had a higher epithelial integrity score than those with mild pneumonia (5.1 ± 0.76 vs 3.8 ± 0.75; p < 0.01). Patients with severe CRE abnormalities had a longer duration of fever (p < 0.01), higher C-reactive protein (p < 0.01), and lower proportion of blood lymphocytes (p < 0.05) compared to those with mild abnormalities. Patients with a positive bacteria culture had a higher epithelial integrity score compared to those with a negative culture (6.0 ± 0.44 vs 4.8 ± 0.71; p < 0.01).</p><p><strong>Conclusions: </strong>CRE abnormalities are closely related to the severity of MP. These findings extend our current knowledge of MP.</p>","PeriodicalId":21541,"journal":{"name":"Scandinavian Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365548.2014.885658","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32365068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Death due to dengue fever.","authors":"Beuy Joob,&nbsp;Viroj Wiwanitkit","doi":"10.3109/00365548.2014.898335","DOIUrl":"https://doi.org/10.3109/00365548.2014.898335","url":null,"abstract":"Sir, the recent report on death due to dengue fever is very interesting [1]. Assir et al. noted that “ dengue shock syndrome and expanded dengue syndrome were the most common causes of death ” [1]. In fact, dengue shock syndrome is the most serious form of dengue and is usually the common cause of death of the patients [2]. There are some reports attempting to identify the risk of fatality in dengue. Thein et al. reported that co-morbidities are important risks [3]. Branco et al. noted that the presentation of overt bleeding was the main presentation associated with fatality [4]. However, the exact contributing factor that leads to death in dengue patients is usually improper fl uid replacement therapy [2]. To improve case fatality rates, Nguyen et al. proposed “ intravenous fl uid replacement with special care to avoid fl uid overload ” [5]. Declaration of interest: The authors report no confl icts of interest. The authors alone are responsible for the content and writing of the paper.","PeriodicalId":21541,"journal":{"name":"Scandinavian Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365548.2014.898335","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32249909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Travel health advice: benefits, compliance, and outcome.","authors":"Martin Angelin,&nbsp;Birgitta Evengård,&nbsp;Helena Palmgren","doi":"10.3109/00365548.2014.896030","DOIUrl":"https://doi.org/10.3109/00365548.2014.896030","url":null,"abstract":"<p><strong>Background: </strong>Travel health advice is an important and difficult part of a pre-travel consultation. The aim of this study was to determine whether the travel health advice given is followed by the traveller and whether it affects disease and injury experienced during travel.</p><p><strong>Methods: </strong>A prospective survey study was carried out from October 2009 to April 2012 at the Travel Medicine Clinic of the Department of Infectious Diseases, Umeå University Hospital, Umeå, Sweden. The Travel Medicine Clinic in Umeå is the largest travel clinic in northern Sweden.</p><p><strong>Results: </strong>We included 1277 individuals in the study; 1059 (83%) responded to the post-travel questionnaire. Most visitors (88%) remembered having received travel health advice; among these, 95% found some of the health advice useful. Two-thirds (67%) claimed to have followed the advice, but fell ill during travel to the same extent as those who did not. Younger travellers (< 31 y) found our travel health advice less beneficial, were less compliant with the advice, took more risks during travel, and fell ill during travel to a greater extent than older travellers.</p><p><strong>Conclusions: </strong>Helping travellers stay healthy during travel is the main goal of travel medicine. Younger travellers are a risk group for illness during travel and there is a need to find new methods to help them avoid illness. Travellers find travel health advice useful, but it does not protect them from travel-related illness. Factors not easily influenced by the traveller play a role, but a comprehensive analysis of the benefits of travel health advice is needed.</p>","PeriodicalId":21541,"journal":{"name":"Scandinavian Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365548.2014.896030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32229708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High prevalence of faecal carriage of ESBL-producing Enterobacteriaceae in Norwegian patients with gastroenteritis.","authors":"Silje Bakken Jørgensen,&nbsp;Orjan Samuelsen,&nbsp;Arnfinn Sundsfjord,&nbsp;Sidra Ahmad Bhatti,&nbsp;Ingvild Jørgensen,&nbsp;Thusanth Sivapathasundaram,&nbsp;Truls Michael Leegaard","doi":"10.3109/00365548.2014.896031","DOIUrl":"https://doi.org/10.3109/00365548.2014.896031","url":null,"abstract":"<p><p>We conducted a cross-sectional study to examine the prevalence of faecal carriage of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in patients with gastroenteritis. During April 2011, all faecal samples submitted to our hospital laboratory were examined for ESBL-producing Enterobacteriaceae. Isolates expressing an ESBL phenotype were investigated for the presence of genes encoding broad-spectrum beta-lactamases, ESBLs, carbapenemases, and plasmid-mediated AmpC. Information on age, gender, and travel history was extracted from the laboratory records. In total 273 faecal samples were included. The overall carrier rate in the study population was 15.8%. The ESBL carrier rate among patients with no history of recent travel, or where this information was missing, was 10.3%. In contrast, the carrier rate was 56.3% (odds ratio 16.3, p < 0.001) among patients with a record of travel to Asia. Two ESBL-producing isolates were identified as enteropathogenic Escherichia coli. Co-resistance between third-generation cephalosporins, trimethoprim-sulfamethoxazole, and fluoroquinolones was seen in 49% of isolates. No carbapenemase-producers were found.</p>","PeriodicalId":21541,"journal":{"name":"Scandinavian Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365548.2014.896031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32237108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylaxis and treatment of HIV-1 infection in pregnancy: Swedish recommendations 2013.","authors":"Lars Navér,&nbsp;Jan Albert,&nbsp;Ylva Böttiger,&nbsp;Christina Carlander,&nbsp;Leo Flamholc,&nbsp;Magnus Gisslén,&nbsp;Filip Josephson,&nbsp;Olof Karlström,&nbsp;Lena Lindborg,&nbsp;Veronica Svedhem-Johansson,&nbsp;Bo Svennerholm,&nbsp;Anders Sönnerborg,&nbsp;Aylin Yilmaz,&nbsp;Karin Pettersson","doi":"10.3109/00365548.2014.898333","DOIUrl":"https://doi.org/10.3109/00365548.2014.898333","url":null,"abstract":"<p><p>Prophylaxis and treatment with antiretroviral drugs and elective caesarean section delivery have resulted in very low mother-to-child transmission of HIV during recent years. Updated general treatment guidelines and increasing knowledge about mother-to-child transmission have necessitated regular revisions of the recommendations for the prophylaxis and treatment of HIV-1 infection in pregnancy. The Swedish Reference Group for Antiviral Therapy (RAV) updated the recommendations from 2010 at an expert meeting on 11 September 2013. The most important revisions are the following: (1) ongoing efficient treatment at confirmed pregnancy may, with a few exceptions, be continued; (2) if treatment is initiated during pregnancy, the recommended first-line therapy is essentially the same as for non-pregnant women; (3) raltegravir may be added to achieve rapid reduction in HIV RNA; (4) vaginal delivery is recommended if at > 34 gestational weeks and HIV RNA is < 50 copies/ml and no obstetric contraindications exist; (5) if HIV RNA is < 50 copies/ml and delivery is at > 34 gestational weeks, intravenous zidovudine is not recommended regardless of the delivery mode; (6) if HIV RNA is > 50 copies/ml close to delivery, it is recommended that the mother should undergo a planned caesarean section, intravenous zidovudine, and oral nevirapine, and the infant should receive single-dose nevirapine at 48-72 h of age and post-exposure prophylaxis with 2 drugs; (7) if delivery is preterm at < 34 gestational weeks, a caesarean section delivery should if possible be performed, with intravenous zidovudine and oral nevirapine given to the mother, and single-dose nevirapine given to the infant at 48-72 h of age, as well as post-exposure prophylaxis with 2 additional drugs.</p>","PeriodicalId":21541,"journal":{"name":"Scandinavian Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365548.2014.898333","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32282579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is pulmonary cryptococcosis a unique pathology?","authors":"Bruno Hochhegger,&nbsp;Edson Marchiori,&nbsp;Klaus Irion,&nbsp;Aline Bello,&nbsp;Luiz Carlos Severo","doi":"10.3109/00365548.2013.803294","DOIUrl":"https://doi.org/10.3109/00365548.2013.803294","url":null,"abstract":"We read with great interest the well-written manuscript by Hu et al. [1], who reported pulmonary cryptococcosis (PC) in China. They reported that solitary cavitary pulmonary nodule may be a common computed tomography fi nding in AIDSassociated PC. However, we would like highlight some important aspects. Cryptococcus neoformans was fi rst isolated in 1894 from fermented peach juice by the Italian Francesco Sanfelice [2]. Since that time, this organism has been recovered from numerous locations throughout the world, where its main ecological niche is soil, particularly in association with pigeon excreta [3]. Cryptococci grow as unicellular, encapsulated cells in the asexual state, or as basidiomycetous fi laments in the sexual state [2]. Infection due to this opportunistic fungus is believed to occur by inhalation and primarily targets the lung, with frequent dissemination to the central nervous system, as well as a variety of other organs [2]. Cryptococcus gattii was fi rst isolated from a leukemic patient in 1970 and described as a variant of C. neoformans [4]. However, C. gattii (formerly Cryptococcus neoformans var. gattii) [2] is a basidiomycetous yeast that is pathogenic to immunocompetent mammals including humans. This relatively uncommon organism differs from the congeneric, more commonly encountered pathogen C. neoformans, with regards to phenotypic characteristics, natural habitat, epidemiology, ecology, clinical manifestations of disease, and responses to antifungal therapy [5]. Phylogenetic studies have shown that C. gattii and C. neoformans diverged from a common ancestor approximately 40 million years ago [3]. C. gattii has the ability to inhibit polymorphonuclear leukocyte (PMN) migration to the site of the organism [2,3], which may promote survival of the extracellular organisms, and can multiply locally to form cryptococcomas that can potentially be misdiagnosed as malignancies [1 – 4]. Compared to C. neoformans, C. gattii infections more often cause granulomatous lesions (cryptococcomas) in the lung and brain, with more associated neurological sequelae and morbidity [6 – 9]. Because of these data, we do not believe that pulmonary cryptococcosis can only be regarded as a unique pathology.","PeriodicalId":21541,"journal":{"name":"Scandinavian Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00365548.2013.803294","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32255654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}