Gastric cryptococcosis: an unusual presentation of a common opportunistic disorder

Endoscopic Findings of Gastric Cryptococcosis in an Immunosuppressed Patient

“…6,7 The clinical presentation can be unspecific ranging from dysphagia, dyspepsia, epigastric pain, nausea, vomiting, and diarrhea to upper GI bleeding. 2,5 Our patient presented with persistent vomiting and epigastric pain, which has been reported before by Eyer-Silva et al 4 in a 34-year-old patient with a previous diagnosis of HIV and a low CD4 count. In endoscopy, cryptococcosis infection can have different presentations, and there is no pathognomonic lesion.…”

“…In patients undergoing endoscopy, findings can vary from gastric ulcers, nodules, and whitish petechiae. [2][3][4][5] Gastric cryptococcosis is usually a manifestation of a disseminated infection, and the prognosis in most case reports is poor.…”

Colonic cryptococcosis as a rare presentation in HIV infection: a case report and review of the literature

“…[19][20][21] In HIV and gastrointestinal cryptococcal coinfection, the most frequent localization is in the small intestine (duodenum, 6,[9][10][11]13,16,17,22 jejunum and ileum 12,14 ). The gastrointestinal injuries were ulcers and perforation, 9,10,12,14,18 and mucosal patch injuries. 6,7 Most cases described involvement of the central nervous system (CNS), [6][7][8][9][10]13,14,16,18 unlike our patient.…”

“…CAT that included amphotericin B had better results 7,[12][13][14]17,21 in contrast with only one antifungal, either fluconazole 8,10 or amphotericin B. 16,18 In non-HIV patients, clinical manifestations are abdominal pain 15,[23][24][25][26][27] and melena 23,28 ; seven of these reports described a secondary immunosuppressive condition. 15,23,[25][26][27]29,30 Characteristics of gastrointestinal injuries were mass-like lesions, 26,28 lymphadenopathies, 23,25 ulcers, 15,23,27,29,30 and perforations.…”

“…In PLWH with severe immunosuppression (WHO clinical stage 3–4) with CD4 <50 cells/µL, gastrointestinal cryptococcal infection manifestations are chronic diarrhea, 6–11 fever, 6–9 , 12 , 13 and abdominal pain 6 , 7 , 10 , 12–18 in those without ART, and abdominal pain with peritoneal irritation and fever in those that recently started ART. 19–21…”