Cryptococcal meningoencephalitis and pulmonary nodule in a non-HIV-infected immunocompetent patient

Lambertucci, José Roberto; Franco, Ricardo; Queiroz, Leonardo Campos de

doi:10.1590/s0037-86822005000200020

Cited by 5 publications

(1 citation statement)

References 2 publications

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“…3 Entry into the body via respiratory inhalation and ability to grow preferentially in the CNS leads to simultaneous pulmonary and CNS involvement on presentation, noted among multiple case reports on our literature review. 6,7 Disseminated cryptococcus may involve multiple organ structures, with common sites including skin, lungs, eyes, and CNS, but has also been seen to affect bone and soft tissue. 2,6 Cryptococcus neoformans meningoencephalitis is a rare cause of disease in immunocompetent individuals.…”

Section: Discussionmentioning

confidence: 99%

Cryptococcal Meningitis in an Apparent Immunocompetent Patient

Poley

Koubek

Walsh

et al. 2019

Journal of Investigative Medicine High Impact Case Reports

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Cryptococcal meningitis is an uncommon and severe infection that tends to affect immunocompromised hosts worldwide and in the United States. Annually it is estimated that there are 200 000 cases of cryptococcal meningitis, with the most recent estimate of 3400 cases per year in the United States alone. However, despite the low incidence, 1-year mortality is estimated at 20% to 30% even with long-term consolidation antifungal therapy. A 37-year-old man presented to the emergency department with headaches, dysarthria, hallucinations, and acute worsening of altered mental status, and he was found to have increased intracranial pressure, cerebrospinal fluid leukocytosis, and few encapsulated yeasts consistent with Cryptococcus neoformans meningitis in addition to radiologic evidence consistent with a cryptococcoma of the lungs. This report highlights the occurrence of Cryptococcus neoformans meningitis in a presumed immunocompetent host. The clinician should be aware of sources of minor immunosuppression, as they may contribute to development of Cryptococcus neoformans meningitis. Mortality in this condition remains high due to subacute presentations and delayed diagnosis in non-immunocompromised patients.

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Section: Discussionmentioning

confidence: 99%

Cryptococcal Meningitis in an Apparent Immunocompetent Patient

Poley

Koubek

Walsh

et al. 2019

Journal of Investigative Medicine High Impact Case Reports

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Cryptococcal Meningitis in Young, Immunocompetent Patients: A Single-Center Retrospective Case Series and Review of the Literature

Stack

Hiles

Valinetz

et al. 2023

Open Forum Infectious Diseases

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Background Cryptococcal meningitis is an uncommon but serious infection with a high mortality and morbidity. Classically described in immunocompromised patients, including those with solid organ transplants or HIV/AIDS, cryptococcosis has also been reported in young and otherwise healthy patients, albeit rarely. Methods We retrospectively searched for all cases of cryptococcal meningitis in young (≤50 years) and previously healthy patients with no known immunocompromising conditions from January 2015 to January 2022 at Indiana University Health (IU Health). Additionally, a PubMed literature review was performed with the keywords “cryptococcal meningitis” and “immunocompetent” from January 1988 to January 2022. Clinical courses, including outcomes and treatment regimens were evaluated. Results We identified 4 local cases of cryptococcal meningitis in otherwise healthy patients ≤50 years. Three cases were due to Cryptococcus neoformans with one experiencing a post-infectious inflammatory response syndrome (PIIRS). The PubMed search identified 51 additional cases with 32 (63%) being caused by Cryptococcus neoformans and 8 (17%) by Cryptococcus gattii. Of the 51 cases, only two resulted in death directly due to cryptococcosis. Fifteen (29%) had PIIRS with steroid treatment documented in 11 of 15. Antifungal induction regimens and duration were varied but predominately consisted of amphotericin and flucytosine with a mean induction duration of 5.0 weeks. Conclusions Cryptococcal meningitis in young, previously healthy patients is likely under-recognized. PIIRS (akin to IRIS observed in HIV/AIDS) with prolonged recovery should be of concern. Determining risks factors for cryptococcosis in these patients remains elusive.

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Chronic meningitis: a diagnostic challenge highlighted in a case of cryptococcal meningoencephalitis in an apparently immunocompetent older woman

Patel

Rabindra²,

Hashemi³

et al. 2011

Case Reports

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Chronic meningitis can be difficult to diagnose. The authors report the case of an older Caucasian lady, with no underlying immunocompromising factors, who presented with a 2 month history of confusion. Due to the non-specific symptoms on presentation, a diagnosis was only obtained after a repeat CT scan of the brain, which showed hydrocephalus. Subsequent cerebrospinal fluid analysis showed biochemical abnormalities and Cryptococcus neoformans on staining.

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Cryptococcal meningoencephalitis and pulmonary nodule in a non-HIV-infected immunocompetent patient

Cited by 5 publications

References 2 publications

Cryptococcal Meningitis in an Apparent Immunocompetent Patient

Cryptococcal Meningitis in an Apparent Immunocompetent Patient

Cryptococcal Meningitis in Young, Immunocompetent Patients: A Single-Center Retrospective Case Series and Review of the Literature

Chronic meningitis: a diagnostic challenge highlighted in a case of cryptococcal meningoencephalitis in an apparently immunocompetent older woman

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