1. Figure 4 Host damage from infection-related inflammatory
syndromes in HIV-positive and in HIV-negative cryptococcal meningitis
Figure 4 | Host damage from infection-related inflammatory syndromes in HIV-positive and in HIV-negative cryptococcal meningitis. Some HIV-positive cryptococcal meningitis (CM) patients who initially improve with antifungal therapy later re-present with CM-associated immune reconstitution inflammatory syndrome after initiation of effective antiretroviral therapy. Such patients present with clinical deterioration although CSF cultures do not show active infection, and an aggravated T-cell and proinflammatory macrophage response. HIV-negative, previously healthy patients with CM may deteriorate clinically despite effective antifungal therapy and negative CSF cultures, with a similar post-infectious immune response syndrome consisting of a similar T-cell response but a defective M2 macrophage polarization that is ineffective in clearing fungal antigen. Man, mannose; TLR2, Toll-like receptor 2.
Williamson, P. R. et al. (2016) Cryptococcal meningitis: epidemiology, immunology, diagnosis and therapy
Nat. Rev. Neurol. doi: /nrneurol