{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T07:11:11Z","timestamp":1771485071008,"version":"3.50.1"},"reference-count":23,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASM Case Rep"],"published-print":{"date-parts":[[2025,1,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:sec>\n              <jats:title>Background<\/jats:title>\n              <jats:p>\n                Meningitis due to\n                <jats:italic toggle=\"yes\">Cryptococcus neoformans<\/jats:italic>\n                continues to\n                            cause substantial morbidity and mortality in victims of this infection.\n                            Worldwide, immunosuppression due to uncontrolled HIV disease is the main\n                            risk factor. In the United States, however, a substantial percentage of\n                            cryptococcal meningitis cases occur in people with non-HIV immune\n                            compromising conditions such as solid organ transplantation.\n                            Neurological damage in cryptococcal meningitis can be caused by direct\n                            fungal-induced injury, as a consequence of elevated intracranial\n                            pressure, and by immune-mediated injury. An understanding of these\n                            pathophysiological processes and an appreciation for the roles of\n                            specific treatments to address them are necessary for optimal care of\n                            patients with cryptococcal meningitis.\n              <\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n              <jats:title>Case Summary<\/jats:title>\n              <jats:p>In this report, we present a case of cryptococcal meningitis in a liver\n                            transplant recipient whose disease manifestations were due to (i) fungal\n                            invasion, (ii) elevated intracranial pressure, and (iii) an\n                            over-exuberant immune response that blossomed soon after reduction of\n                            immunosuppression and clearance of cerebrospinal fluid culture.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n              <jats:title>Conclusion<\/jats:title>\n              <jats:p>This patient\u2019s course exemplifies the multidimensional nature of\n                            neurological injury in cryptococcal meningitis and the diverse treatment\n                            strategies required to address the infection and complications.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n              <jats:title>IMPORTANCE<\/jats:title>\n              <jats:p>An understanding of the pathophysiological processes that cause\n                            neurological damage in cryptococcal meningitis is critical for optimal\n                            management of patients with this infection. This case highlights three\n                            such processes so that they can be quickly diagnosed and treated before\n                            irreversible damage occurs.<\/jats:p>\n            <\/jats:sec>\n          <\/jats:sec>","DOI":"10.1128\/asmcr.00040-24","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T09:00:12Z","timestamp":1733994012000},"source":"Crossref","is-referenced-by-count":1,"title":["Multiple dimensions of neurological injury in a liver transplant                    recipient with cryptococcal meningitis"],"prefix":"10.1128","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7276-7786","authenticated-orcid":false,"given":"Shmuel","family":"Shoham","sequence":"first","affiliation":[{"name":"Department of Medicine, Johns Hopkins University School of Medicine","place":["Baltimore, 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