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Doumbo SN, Cissoko Y, Dama S, Niangaly A, Garango A, Konaté A, Koné A, Traoré B, Thera M, Djimde A, Denning DW. The estimated burden of fungal diseases in Mali. J Mycol Med 2023; 33:101333. [PMID: 36270216 DOI: 10.1016/j.mycmed.2022.101333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022]
Abstract
Mali is a developing country facing several health challenges with a high rate of tuberculosis (TB) and a moderate HIV infection burden. Little is known or done about fungal diseases, yet they represent a significant public health problem in certain populations. The aim of this study was to estimate the national burden of fungal disease, and summarize data, diagnostic and treatment gaps. We used national demographics and PubMed searches to retrieve articles on published data on these infections and at-risk populations (pulmonary TB, HIV/AIDS patients, patients receiving critical care etc.) in Mali. The estimated Malian population was 21,251,000 in 2020 (UN), of which 45% were children <14 years. Among HIV patients, we estimate an annual incidence of 611 cryptococcosis, 1393 Pneumocystis pneumonia, 180 histoplasmosis and >5,700 esophageal candidiasis and some microsporidiosis cases. Our prevalence estimates for tinea capitis are 2.3 million, for recurrent vulvovaginal candidiasis 272,460, ∼60,000 fungal asthma and 7,290 cases of chronic pulmonary aspergillosis (often mistaken for TB). Less common acute fungal infections are probably invasive aspergillosis (n=1230), fungal keratitis (n=2820), candidaemia (>1,060) and mucormycosis (n=43). Histoplasmin was found in 6% in general population. A few cases of mycetoma are described in Mali. Many WHO Essential medicines and Diagnostics are not available in Mali. This shows a marked disparity in documented and estimated cases of fungal diseases in Mali. These infections are underestimated due to the lack of accurate diagnosis tools and lack of support for fungal diseases diagnosis and management.
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Affiliation(s)
- Safiatou Niaré Doumbo
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali.
| | - Yacouba Cissoko
- Infectious disease and tropical medicine Unit, CHU Point G Bamako, Mali
| | - Souleymane Dama
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - Amadou Niangaly
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - Adam Garango
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - Ahmed Konaté
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - Abdoulaye Koné
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - Boubacar Traoré
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - Mahamadou Thera
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - Abdoulaye Djimde
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - David W Denning
- Manchester Fungal Infection Group, Core Technology Facility Grafton Street, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; Global Action for Fungal Infections, Geneva, Switzerland
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Jia Z, Tang M, Zhang X, Xin X, Jiang W, Hao J. Isolated cryptococcosis of a lumbar vertebra in an immunocompetent patient: A case report and literature review. Front Surg 2023; 9:1079732. [PMID: 36684372 PMCID: PMC9852703 DOI: 10.3389/fsurg.2022.1079732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 11/21/2022] [Indexed: 01/09/2023] Open
Abstract
Background Cryptococcus, a kind of fungus, can be found in soil, decayed wood, and avian excreta. Immunocompromised patients are prone to infection caused by Cryptococcus, and the lungs and central nervous system are the main target organs. Cryptococcosis rarely occurs in the lumbar vertebra or in immunocompetent patients. Case presentation A 40-year-old adult male with isolated lumbar vertebra cryptococcosis at the L4 vertebra underwent successful lesion removal surgery performed via the posterior approach and postoperative administration of an antifungal agent. At the 12-month follow-up, the patient's pain was relieved, and his motor function had improved. Isolated Cryptococcus vertebrae infection is a rare infectious disease. Conclusions A needle biopsy can confirm the diagnosis of Cryptococcus infection. When patients present with unbearable symptoms of nerve compression, posterior depuration combined with postoperative antifungal agents is a good option.
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Affiliation(s)
- Zhongxiong Jia
- Department of Orthopedics, The Second People's Hospital of Yibin, Yibin, China
| | - Min Tang
- Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaojun Zhang
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaojuan Xin
- Infectious Disease Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Jiang
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Hao
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China,Correspondence: Jie Hao
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Akaihe CL, Nweze EI. Epidemiology of Cryptococcus and cryptococcosis in Western Africa. Mycoses 2020; 64:4-17. [PMID: 32969547 DOI: 10.1111/myc.13188] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/07/2020] [Accepted: 09/11/2020] [Indexed: 12/22/2022]
Abstract
Cryptococcosis is a serious and sometimes fatal fungal disease caused by Cryptococcus species. Worldwide, it is estimated to kill over 180 000 annually, with 75% of deaths occurring in sub-Saharan Africa. Though cryptococcal infections are rare in otherwise healthy individuals, there have been reported cases in immunocompetent persons. Most cases occur in individuals who have weakened immune systems, particularly those with advanced HIV/AIDS, thus making West Africa a potential hotspot of the disease. Despite this, there is no recent review article with a focus on published findings on cryptococcosis in Western Africa. Common clinical symptoms include chest pain, dry cough, headache, nausea, confusion, fever, fatigue and stiffness of the neck/neurological impairment. The CNS and the lung remain its preferred target even though rare cases of attack on other parts of the body were reported in this review. Cryptococcal antigen screening and India ink preparation were the most commonly used diagnostic methods. Repeated isolation from environmental samples was observed. Overall, data on the clinical prevalence of Cryptococcus are scarce and variable in the region. The environmental prevalence ranges from 2.3% to 22%. This review covers all published research findings on cryptococcosis in West Africa till date. The epidemiological data will likely be of interest to clinicians within and outside the continent. The nations covered in this review include the following: Benin Republic, Burkina Faso, Cote d'ivoire, Ghana, Guinea, Guinea- Bissau, Mali, Nigeria, Senegal and Sierra Leone. More studies are warranted to fill the observed gaps on the epidemiology of Cryptococcus in the region.
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El Fane M, Badaoui L, Ouladlahsen A, Sodqi M, Marih L, Chakib A, Marhoum El Filali K. [Cryptococcosis during HIV infection]. J Mycol Med 2015; 25:257-62. [PMID: 26515783 DOI: 10.1016/j.mycmed.2015.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 09/21/2015] [Accepted: 09/21/2015] [Indexed: 11/26/2022]
Abstract
Cryptococcosis is a cosmopolitan fungal serious condition due to an encapsulated yeast Cryptococcus neoformans. This is the systemic fungal infection the most common in HIV infection. This yeast is present in the environment and its main entrance in the body is the respiratory tract. Its gravity is linked to its tropism for the central nervous system. It generally affects subjects with severe deficit of cellular immunity and in particular, patients living with HIV. The diagnosis of neuromeningeal cryptococcosis is based on the detection of encapsulated yeasts at microscopic examination of cerebrospinal fluid, the detection of capsular polysaccharide antigen in serum or cerebrospinal fluid, but especially on the culture. A staging is always essential. The prognosis is severe. The control of intracranial hypertension is a major element of prognosis.
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Affiliation(s)
- M El Fane
- Service des maladies infectieuses, CHU Ibn Rochd, Casablanca, Maroc.
| | - L Badaoui
- Service des maladies infectieuses, CHU Ibn Rochd, Casablanca, Maroc
| | - A Ouladlahsen
- Service des maladies infectieuses, CHU Ibn Rochd, Casablanca, Maroc
| | - M Sodqi
- Service des maladies infectieuses, CHU Ibn Rochd, Casablanca, Maroc
| | - L Marih
- Service des maladies infectieuses, CHU Ibn Rochd, Casablanca, Maroc
| | - A Chakib
- Service des maladies infectieuses, CHU Ibn Rochd, Casablanca, Maroc
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Elkhihal B, Hasnaoui A, Ghfir I, Moustachi A, Aoufi S, Lyagoubi M. [Disseminated cryptococcosis in an immunocompetent patient]. J Mycol Med 2015; 25:208-12. [PMID: 26227506 DOI: 10.1016/j.mycmed.2015.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 05/29/2015] [Accepted: 06/01/2015] [Indexed: 11/28/2022]
Abstract
Disseminated cryptococcosis is a serious opportunistic fungal infection caused by a yeast-encapsulated fungus of the genus Cryptococcus neoformans. It occurs most often in patients with a significant deficit of cellular immunity and preferentially affects the central nervous system. The skin and the lungs are the most commonly affected sites outside the neuro-subarachnoid location. We report the case of a patient apparently immunocompetent who had a disseminated cryptococcosis. The disease started with the multiple purplish skin lesions, large umbilicated on the face, groin, forearm and leg with progressively increasing volume. This symptomatology had evolved in the context of weight loss and poor general condition. The diagnosis was established by the presence of cryptococcal at the skin biopsy and cerebrospinal fluid. Research of immunosuppression common pathologies were negative. Treatment was initiated based on amphotericin B for 40 days. The patient's condition deteriorates onset of paraplegia and swallowing disorders causing death in an array of cachexia. This observation points out that disseminated cryptococcosis can occur in an immunocompetent patient. The skin lesions may be the first sign of the disease.
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Affiliation(s)
- B Elkhihal
- Laboratoire central de parasitologie-mycologie, centre hospitalier Ibn Sina de Rabat, rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc.
| | - A Hasnaoui
- Laboratoire central de parasitologie-mycologie, centre hospitalier Ibn Sina de Rabat, rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc
| | - I Ghfir
- Laboratoire central de parasitologie-mycologie, centre hospitalier Ibn Sina de Rabat, rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc
| | - A Moustachi
- Laboratoire central de parasitologie-mycologie, centre hospitalier Ibn Sina de Rabat, rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc
| | - S Aoufi
- Laboratoire central de parasitologie-mycologie, centre hospitalier Ibn Sina de Rabat, rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc
| | - M Lyagoubi
- Laboratoire central de parasitologie-mycologie, centre hospitalier Ibn Sina de Rabat, rue Lamfadel Cherkaoui, BP 6527, Rabat, Maroc
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Atarguine H, Hocar O, Abbad F, Rais H, Idalene M, Tassi N, Akhdari N, Moutaj R, Amal S. [Cutaneous cryptococcosis mimicking basal cell carcinoma and revealing systemic involvement in acquired immunodeficiency]. J Mycol Med 2015; 25:163-8. [PMID: 25959736 DOI: 10.1016/j.mycmed.2015.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 04/03/2015] [Accepted: 04/11/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cryptococcosis is a rare and a serious opportunistic infection that occurs primarily on the field of immunodeficiency. We report a case of disseminated cryptococcosis in acquired immunodeficiency syndrome revealed by unusual skin lesions. OBSERVATION A 52-year-old patient consulted for two crusty ulcerative lesions situated on the left supraorbital and on the nasal tip that appeared 6 months ago. He also reported respiratory symptoms present since one year, with dry cough and dyspnea, chronic headache and vomiting with no alteration in visual acuity. The mycological study of the skin biopsy on both lesions isolated Cryptococcus neoformans as well as in the sputum and cerebrospinal fluid. Serology of human immunodeficiency virus infection was positive. Treatment with fluconazole, local care and antiretroviral triple therapy was implemented. DISCUSSION Skin lesions during cryptococcosis are rare and observed in 2-10% of cases. Cutaneous symptoms were the reason for consultation in our patient. This is a rare form of cutaneous cryptococcosis leading to the discovery of both pulmonary and central nervous system locations, and to diagnosis of HIV infection.
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Affiliation(s)
- H Atarguine
- Service de dermatologie, faculté de médecine et de pharmacie, université Cadi Ayyad, hôpital Errazi, CHU Mohamed VI, 40000 Marrakech, Maroc.
| | - O Hocar
- Service de dermatologie, faculté de médecine et de pharmacie, université Cadi Ayyad, hôpital Errazi, CHU Mohamed VI, 40000 Marrakech, Maroc
| | - F Abbad
- Service d'anatomie pathologique, faculté de médecine et de pharmacie, université Cadi Ayyad, hôpital Errazi, CHU Mohamed VI, 40000 Marrakech, Maroc
| | - H Rais
- Service d'anatomie pathologique, faculté de médecine et de pharmacie, université Cadi Ayyad, hôpital Errazi, CHU Mohamed VI, 40000 Marrakech, Maroc
| | - M Idalene
- Service de maladies infectieuses, faculté de médecine et de pharmacie, université Cadi Ayyad, hôpital Errazi, CHU Mohamed VI, 40000 Marrakech, Maroc
| | - N Tassi
- Service de maladies infectieuses, faculté de médecine et de pharmacie, université Cadi Ayyad, hôpital Errazi, CHU Mohamed VI, 40000 Marrakech, Maroc
| | - N Akhdari
- Service de dermatologie, faculté de médecine et de pharmacie, université Cadi Ayyad, hôpital Errazi, CHU Mohamed VI, 40000 Marrakech, Maroc
| | - R Moutaj
- Service de parasitologie-mycologie médicale, faculté de médecine et de pharmacie, université Cadi Ayyad, hôpital militaire Avicenne, CHU Mohamed VI, 40000 Marrakech, Maroc
| | - S Amal
- Service de dermatologie, faculté de médecine et de pharmacie, université Cadi Ayyad, hôpital Errazi, CHU Mohamed VI, 40000 Marrakech, Maroc
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