Cryptococcal meningitis (CM) is a CNS manifestation of cryptococcosis, a fungal infection caused by Cryptococcus neoformans or Cryptococcus gattii. CM creates a large burden of mortality and morbidity to the patient and is very difficult for clinicians to treat. The newest CDC estimates will put worldwide incidence at 300-400K cases with approximately 175K deaths. It is traditionally seen most commonly in immunocompromised patients, such as those with HIV or in organ-transplant recipients (OTR). CFU reduction and management of ICP in the first 14 days (the induction phase) are the key drivers of patient outcomes. Current gold standard therapy achieves a 5-log reduction of CFUs during the 14-day induction phase, and results in an overall 21% mortality at 90 days in the US. A boost to CSF CFU reduction early in the induction phase via Neurapheresis may assist antifungals in clearing the fungus from the system and alleviate high ICP by preventing fungus from obstructing the arachnoid granulations.
Scientific Advisory Board
- John Perfect, MD (James B. Duke Professor Medicine; Chief, Division of Infectious Disease, Duke University Medical Center)
- Peter Pappas, MD, FACP (William E. Dismukes Professor of Medicine; Principal Investigator, Mycoses Study Group, Division of Infectious Diseases, University of Alabama at Birmingham)
- David Boulware, MD, MPH, CTropMed (Lois & Richard King Distinguished Associate Professor, Division of Infectious Diseases and International Medicine, University of Minnesota)
- Andrej Spec, MD (Assistant Professor of Medicine, Washington University School of Medicine in St. Louis)
John Perfect, MD
James B. Duke Professor of Medicine the Chief of the Division of Infectious Disease
John Perfect, MD is the James B. Duke Professor of Medicine the Chief of the Division of Infectious Disease at Duke University Medical Center. Dr. Perfect is a world-renowned expert in C. neoformans and cryptococcal meningitis, with over 30 years of experience in studying the disease and furthering the state of the art of treatment for cryptococcal meningitis. Dr. Perfect has been instrumental in the design of experiments; the adaptation of Minnetronix’s in vitro and in vivo (rabbit) cryptococcal meningitis model; and providing guidance and insights with clinical applicability. Dr. Perfect received his MD from the University of Toledo in 1974; completed his residency at the University of Michigan in 1977, and completed his fellowship in Infectious Disease at the Duke University School of Medicine in 1980.
Collaborating and Supporting Researchers
- Michael Cohen-Wolkowiez, MD, PhD – Director, Pharmacometrics Center, Duke Clinical Research Institute
- Ivan Spasojevic.,PhD – Associate Professor of Medicine, Department of Medicine-Oncology, Duke University School of Medicine