{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:54:02Z","timestamp":1790283242652,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,12,8]],"date-time":"2018-12-08T00:00:00Z","timestamp":1544227200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Paediatric <jats:italic>Cryptococcus gattii<\/jats:italic> disease is rare, with only two previous cases recorded in the Northern Territory (NT) over the last 54\u2009years. Immune reconstitution inflammatory syndrome (IRIS) is a recognised complication of <jats:italic>C. gattii<\/jats:italic> infection, even in the absence of an identified immunodeficiency syndrome; however, limited paediatric data exist. We present a series of three paediatric patients treated for <jats:italic>C. gattii<\/jats:italic> infection in the NT during 2016\/2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Discussions<\/jats:title><jats:p>All three cases were males aged 8\u201313\u2009years at the time of presentation. Two were Aboriginal Australians from remote NT communities, and the third was a Timorese child from a remote district in Timor\u2010Leste. All cases had evidence of brain cryptococcomas, and two had associated pulmonary lesions. Each child was treated with a 6\u2010week induction phase of intravenous liposomal amphotericin and flucytosine and then continued on a 2\u2010year course of eradication oral fluconazole. Persistent high intracranial pressure (ICP) complicated each case, requiring serial lumbar punctures and, in two cases, insertion of ventriculoperitoneal shunts. All three cases were diagnosed with IRIS between 5 and 10 weeks after commencement of antifungal treatment and were managed with high\u2010dose corticosteroids, which were weaned slowly (6\u201320\u2009months post\u2010commencement).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Paediatric <jats:italic>C. gattii<\/jats:italic> disease is rare, although three recent cases in the NT highlight some of the challenges involved in managing the infection, including persistent raised ICP and complications such as IRIS. There is a need for further collaborative research into paediatric <jats:italic>C. gattii<\/jats:italic> disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.14321","type":"journal-article","created":{"date-parts":[[2018,12,8]],"date-time":"2018-12-08T10:54:31Z","timestamp":1544266471000},"page":"943-947","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["<i>Cryptococcus gattii<\/i> infection complicated by immune reconstitution inflammatory syndrome in three apparently immunocompetent children"],"prefix":"10.1111","volume":"55","author":[{"given":"Matthew P","family":"O'Brien","sequence":"first","affiliation":[{"name":"Department of Paediatrics Royal Darwin Hospital  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J","family":"Ford","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Royal Darwin Hospital  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart J","family":"Currie","sequence":"additional","affiliation":[{"name":"Northern Territory Medical Program Flinders and Charles Darwin Universities  Darwin Northern Territory Australia"},{"name":"Global and Tropical Health Division Menzies School of Health Research, Charles Darwin University  Darwin Northern Territory Australia"},{"name":"Infectious Disease Department, Division of Medicine Royal Darwin Hospital  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua R","family":"Francis","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Royal Darwin Hospital  Darwin Northern Territory Australia"},{"name":"Northern Territory Medical Program Flinders and Charles Darwin Universities  Darwin Northern Territory Australia"},{"name":"Global and Tropical Health Division Menzies School of Health Research, Charles Darwin University  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00126-13"},{"key":"e_1_2_8_3_1","volume-title":"The Yeasts: A Taxonomic Study","author":"Kurtzman C","year":"2011"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1086\/649858"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit341"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2217\/fmb.13.123"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis529"},{"key":"e_1_2_8_8_1","first-page":"689","article-title":"An atypical strain of Cryptococcus neoformans (San Felice) Vuillemin 1894. 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