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Cryptococcal meningitis persists despite 90-90-90 – Botswana experience

July 18 2016

At the EMBO Mycoses in AIDS meeting in Cape Town, Dr Joe Jarvis working in Gabarone, Botswana questioned the value of 90-90-90 in reducing cryptococcal meningitis. Just published in the prestigious journal Lancet HIV, is Botswana's record in rolling our 90-90-90 antiretroviral therapy. Botswana achieved: 83·3% individuals knew their HIV status, among these 87·4%, were receiving ART and 96·5%, had viral load of <400 copies per mL - 70·2% with virological suppression, close to the UNAIDS target of 73%. This performance is probably the best in Africa and exceeds performance for most countries across the world, with the exception of several European countries.
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Symptomatic adrenal histoplasmosis – suspicion and diagnosis

July 14 2016

Adrenal histoplasmosis is uncommon but a very important diagnosis. While tuberculosis may be numerically more common, Histoplasma capsulatum, is a very important differential diagnosis. Histoplasma has a remarkable predeliction for the adrenal gland, unlike any other fungi or bacteria. Adrenal histoplasmosis is usually bilateral (1, 2). Dr Smeeta Gajendra and colleagues from Gurgaon, India describe 12 cases of adrenal histoplasmosis seen in 2 years (3). All were immunocompetent males and occurred in a non-endemic area. They presented with nonspecific symptoms and clinical signs and all had markedly impaired adrenal insufficiency. Ten patients had bilateral involvement. 18F-FDG PET/CT in 10 patients showed high FDG uptake in the adrenals (Figure 1). All the patients had histopathological/cytological proven disease (Figure 2). Two patients had simultaneous histoplasmosis in other sites, one in the epiglottitis and the other in the alveolus.
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Mycotic keratitis among sugarcane farmers caused by Fusarium Sacchari

July 11 2016

Mycotic keratitis is an inflammation of the cornea, as a result of infection with yeast or filamentous fungi. Risk factors include ocular trauma, contact lenses, prolonged use of topical steroids, diabetes and pre-existing ocular diseases. The incidence of F. sacchari keratitis reported here is higher than previous reports.
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Low (1,3)-beta-D-glucan in Candida parapsilosis infections

July 04 2016

(1,3)-beta-D-glucan (BGD) is a useful, rapid test for deep Candida infections, but is lower in those with C. parapsilosis infection. Drs Mikulska, Giacobbe and colleagues from Genoa, Italy evaluated 107 patients with positive blood cultures for a single Candida species against their BDG level (Fungitell). The BDG cutoff used was >80 pg/ml. BDG was positive in 63 of 107 patients (59%) but remarkable differences in BDG levels among different species. For C. albicans (n=46) sensitivity was 72%, compared with 41% for C. parapsilosis (n=37); it was positive in 63% for other species. Median levels of BDG in patients with C. parapsilosis infection were 39pg/mL compared to 410 and 149 pg/mL for C. albicans and other species (p=0.003).
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Royal Society summer science exhibition: killer fungus

July 04 2016

The Royal Society launches it's summer exhibition today 4th-10th July 2016 - it is a free festival of visionary science and technology. Amongst the 22 exhibits one entitled Global fungal killers and life-threatening infections discusses the role of fungi in lethal infections and how there is an unmet need to for better treatment of fungal infections worldwide.ibi Turn up to the free exhibition with plenty more to see and learn, at 6-9 Carlton House Terrace, London SW1Y 5AG, If you cant get to the exhbition take a look at their video about killer fungus here:
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