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We report the case of a 71-year-old male with poorly controlled diabetes mellitus who presented with lower extremity edema and acute renal failure. He was diagnosed with nephrotic syndrome secondary to minimal change disease (MCD). Treatment with steroids was withheld due to concern for hyperglycemia in the context of his poorly controlled diabetes mellitus. A week after discharge, he was subsequently re-hospitalized four times within a month with pleural effusions, dyspnea, and fever. Work up revealed isolated pleural cryptococcosis, demonstrated on two separate admissions. There was neither evidence of disseminated disease nor immunocompromising condition. Immunosuppression was not initiated for the treatment of MCD in the setting of poorly controlled diabetes and active infection. After six months of treatment with fluconazole 400 mg/day, the nephrotic syndrome, renal failure, and cryptococcal pleuritis resolved. This case is the first to our knowledge of isolated pleural cryptococcosis associated with nephrotic syndrome. The patient’s course lends further support to the hypothesis that there may be causal relationship between cryptococcosis and nephrotic syndrome.

Previous studies worldwide have suggested the potential role of bioaerosols as ice-nuclei and cloud-condensation nuclei. Furthermore, their participation in regulating the global carbon cycle urges systematic studies from different environmental conditions throughout the globe. Towards this through one-year study, conducted from June 2015-May 2016, we report on atmospheric abundance and variability of viable bioaerosols, organic carbon (OC) and particles number and deduced mass concentrations from Indo-Gangetic Plain (IGP; at Kanpur). Among viable bioaerosols, the highest concentrations of Gram-positive bacteria (GPB), Gram-negative bacteria (GNB) and Fungi were recorded during December-January (Avg.: 189 CFU/m3), November (244 CFU/m3) and September months (188 CFU/m3), respectively. Annual average concentration of GPB, GNB and Fungi were 105 ± 58, 144 ± 82 and 116 ± 51 CFU/m3. Particle number concentration (PNC) associated with fine-fraction aerosols (FFA) predominates throughout the year. However, mineral dust (coarser particle) remains a perennial constituent of atmospheric aerosols over the IGP. Temporal variability records and significant positive linear relationship (p < 0.05) of GPB and GNB with OC and biomass burning derived potassium (K+BB) indicates their association with massive emissions from paddy-residue burning (PRB) and bio-fuel burning. Influence of meteorological parameters on viable bioaerosols abundance has been rigorously investigated herein. Accordingly, ambient temperature seems to be more affecting the bacteria (anti-correlation), whereas wet-precipitation (1-4 mm) relates to higher abundance of Fungi. High abundance of GNB during large-scale biomass burning emissions has implications to endotoxin exposure on human health. Field-based data-set of bioaerosols, OC, PNC and deduced mass concentrations reported herein could serve to better constraint their role in human health and climate relevance. [ABSTRACT FROM AUTHOR]