Skip to main content
PMC home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1996 Jan;34(1):218–221. doi: 10.1128/jcm.34.1.218-221.1996

D-mannitol in cerebrospinal fluid of patients with AIDS and cryptococcal meningitis.

G M Megson 1, D A Stevens 1, J R Hamilton 1, D W Denning 1
PMCID: PMC228768  PMID: 8748311

Abstract

Cryptococcal meningitis (CM) is associated with raised intracranial pressure which is linked with serious neurological sequelae. Cryptococcus neoformans produces D-mannitol in vitro and in experimental meningitis in rabbits. Mannitol present in the cerebrospinal fluid (CSF) of CM patients could exacerbate raised intracranial pressure and contribute to neurological damage. To link CSF mannitol to cryptococcal infection, levels of mannitol in the CSF of AIDS patients with CM were measured by gas-liquid chromatography. Mannitol was detected in 19 of 21 samples (range, 1.5 to 26.2 mg/liter), but there was no quantitative correlation between the mannitol concentration and the cryptococcal antigen titer.

Full Text

The Full Text of this article is available as a PDF (174.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Denning D. W., Armstrong R. W., Lewis B. H., Stevens D. A. Elevated cerebrospinal fluid pressures in patients with cryptococcal meningitis and acquired immunodeficiency syndrome. Am J Med. 1991 Sep;91(3):267–272. doi: 10.1016/0002-9343(91)90126-i. [DOI] [PubMed] [Google Scholar]
  2. Diamond R. D., Root R. K., Bennett J. E. Factors influencing killing of Cryptococcus neoformans by human leukocytes in vitro. J Infect Dis. 1972 Apr;125(4):367–376. doi: 10.1093/infdis/125.4.367. [DOI] [PubMed] [Google Scholar]
  3. Erlich S. S., McComb J. G., Hyman S., Weiss M. H. Ultrastructure of the orbital pathway for cerebrospinal fluid drainage in rabbits. J Neurosurg. 1989 Jun;70(6):926–931. doi: 10.3171/jns.1989.70.6.0926. [DOI] [PubMed] [Google Scholar]
  4. Hamilton J. R., Noble A., Denning D. W., Stevens D. A. Performance of cryptococcus antigen latex agglutination kits on serum and cerebrospinal fluid specimens of AIDS patients before and after pronase treatment. J Clin Microbiol. 1991 Feb;29(2):333–339. doi: 10.1128/jcm.29.2.333-339.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Kiehn T. E., Bernard E. M., Gold J. W., Armstrong D. Candidiasis: detection by gas-liquid chromatography of D-arabinitol, a fungal metabolite, in human serum. Science. 1979 Nov 2;206(4418):577–580. doi: 10.1126/science.493963. [DOI] [PubMed] [Google Scholar]
  6. Minns R. A., Engleman H. M. The use of CSF pressure recordings in acute purulent meningitis. Z Kinderchir. 1988 Dec;43 (Suppl 2):28–29. doi: 10.1055/s-2008-1044151. [DOI] [PubMed] [Google Scholar]
  7. Nelson M. R., Bower M., Smith D., Reed C., Shanson D., Gazzard B. The value of serum cryptococcal antigen in the diagnosis of cryptococcal infection in patients infected with the human immunodeficiency virus. J Infect. 1990 Sep;21(2):175–181. doi: 10.1016/0163-4453(90)91727-u. [DOI] [PubMed] [Google Scholar]
  8. Niehaus W. G., Flynn T. Regulation of mannitol biosynthesis and degradation by Cryptococcus neoformans. J Bacteriol. 1994 Feb;176(3):651–655. doi: 10.1128/jb.176.3.651-655.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Pickard J. D., Czosnyka M. Management of raised intracranial pressure. J Neurol Neurosurg Psychiatry. 1993 Aug;56(8):845–858. doi: 10.1136/jnnp.56.8.845. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Powderly W. G., Cloud G. A., Dismukes W. E., Saag M. S. Measurement of cryptococcal antigen in serum and cerebrospinal fluid: value in the management of AIDS-associated cryptococcal meningitis. Clin Infect Dis. 1994 May;18(5):789–792. doi: 10.1093/clinids/18.5.789. [DOI] [PubMed] [Google Scholar]
  11. Powderly W. G. Cryptococcal meningitis and AIDS. Clin Infect Dis. 1993 Nov;17(5):837–842. doi: 10.1093/clinids/17.5.837. [DOI] [PubMed] [Google Scholar]
  12. Rex J. H., Larsen R. A., Dismukes W. E., Cloud G. A., Bennett J. E. Catastrophic visual loss due to Cryptococcus neoformans meningitis. Medicine (Baltimore) 1993 Jul;72(4):207–224. doi: 10.1097/00005792-199307000-00001. [DOI] [PubMed] [Google Scholar]
  13. Rudehill A., Gordon E., Ohman G., Lindqvist C., Andersson P. Pharmacokinetics and effects of mannitol on hemodynamics, blood and cerebrospinal fluid electrolytes, and osmolality during intracranial surgery. J Neurosurg Anesthesiol. 1993 Jan;5(1):4–12. doi: 10.1097/00008506-199301000-00002. [DOI] [PubMed] [Google Scholar]
  14. Wong B., Perfect J. R., Beggs S., Wright K. A. Production of the hexitol D-mannitol by Cryptococcus neoformans in vitro and in rabbits with experimental meningitis. Infect Immun. 1990 Jun;58(6):1664–1670. doi: 10.1128/iai.58.6.1664-1670.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES