{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:20:13Z","timestamp":1790281213959,"version":"4.1.0"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2017,8,23]],"date-time":"2017-08-23T00:00:00Z","timestamp":1503446400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2017,8,23]],"date-time":"2017-08-23T00:00:00Z","timestamp":1503446400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>CNS cryptococcal meningoencephalitis in both HIV positive (HIV+) and HIV negative (HIV\u2212) subjects is associated with high morbidity and mortality despite optimal antifungal therapy. We thus conducted a detailed analysis of the MR imaging findings in 45 HIV\u2212 and 11 HIV+ patients to identify imaging findings associated with refractory disease. Ventricular abnormalities, namely ependymitis and choroid plexitis were seen in HIV\u2212 but not in HIV+ subjects. We then correlated the imaging findings in a subset of HIV\u2212 subjects (n\u2009=\u200917) to CSF levels of neurofilament light chain (NFL), reflective of axonal damage and sCD27, known to best predict the presence of intrathecal T-cell mediated inflammation. We found that ependymitis on brain MRI was the best predictor of higher log(sCD27) levels and choroid plexitis was the best predictor of higher log(NFL) levels. The availability of predictive imaging biomarkers of inflammation and neurological damage in HIV\u2212 subjects with CNS cryptococcosis may help gauge disease severity and guide the therapeutic approach in those patients.<\/jats:p>","DOI":"10.1038\/s41598-017-09694-0","type":"journal-article","created":{"date-parts":[[2017,8,17]],"date-time":"2017-08-17T09:25:23Z","timestamp":1502961923000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Choroid Plexitis and Ependymitis by Magnetic Resonance Imaging are Biomarkers of Neuronal Damage and Inflammation in HIV-negative Cryptococcal Meningoencephalitis"],"prefix":"10.1038","volume":"7","author":[{"given":"Dima A.","family":"Hammoud","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Mahdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil A.","family":"Panackal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Wakim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Sheikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irini","family":"Sereti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibi","family":"Bielakova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Bennett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter R.","family":"Williamson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2017,8,23]]},"reference":[{"key":"9694_CR1","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1097\/QAD.0b013e328322ffac","volume":"23","author":"BJ Park","year":"2009","unstructured":"Park, B. J. et al. Estimation of the current global burden of cryptococcal meningitis among persons living with HIV\/AIDS. AIDS (London, England) \n                           23, 525\u2013530, doi:10.1097\/QAD.0b013e328322ffac (2009).","journal-title":"AIDS (London, England)"},{"key":"9694_CR2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0043582","volume":"7","author":"EW Bratton","year":"2012","unstructured":"Bratton, E. W. et al. Comparison and temporal trends of three groups with cryptococcosis: HIV-infected, solid organ transplant, and HIV-negative\/non-transplant. PloS one \n                           7, e43582, doi:10.1371\/journal.pone.0043582 (2012).","journal-title":"PloS one"},{"key":"9694_CR3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0056269","volume":"8","author":"V Pyrgos","year":"2013","unstructured":"Pyrgos, V., Seitz, A. E., Steiner, C. A., Prevots, D. R. & Williamson, P. R. Epidemiology of cryptococcal meningitis in the US: 1997\u20132009. 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Fungal burden, early fungicidal activity, and outcome in cryptococcal meningitis in antiretroviral-naive or antiretroviral-experienced patients treated with amphotericin B or fluconazole. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America \n                           45, 76\u201380, doi:10.1086\/518607 (2007).","journal-title":"Clinical infectious diseases: an official publication of the Infectious Diseases Society of America"},{"key":"9694_CR8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0159727","volume":"11","author":"JM Montezuma-Rusca","year":"2016","unstructured":"Montezuma-Rusca, J. M. et al. Early Fungicidal Activity as a Candidate Surrogate Endpoint for All-Cause Mortality in Cryptococcal Meningitis: A Systematic Review of the Evidence. 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BMC neurology \n                           11, 12, doi:10.1186\/1471-2377-11-12 (2011).","journal-title":"BMC neurology"},{"key":"9694_CR17","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.jns.2016.02.062","volume":"364","author":"YF Chen","year":"2016","unstructured":"Chen, Y. F. et al. Risk factors associated with acute\/subacute cerebral infarction in HIV-negative patients with cryptococcal meningitis. Journal of the neurological sciences \n                           364, 19\u201323, doi:10.1016\/j.jns.2016.02.062 (2016).","journal-title":"Journal of the neurological sciences"},{"key":"9694_CR18","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1016\/j.jns.2013.08.010","volume":"334","author":"R Dubbioso","year":"2013","unstructured":"Dubbioso, R. et al. Atypical clinical and radiological presentation of cryptococcal choroid plexitis in an immunocompetent woman. 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