Fulminant intracranial hypertension due to cryptococcal meningitis in a child with nephrotic syndrome

Nagotkar, Leena; Shanbag, Preeti; Mauskar, Anupama; Zaki, Syed Ahmed; Kumar, Chaya A.

doi:10.4103/0972-5229.84905

Cited by 7 publications

(2 citation statements)

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“…Usually, the symptoms disappear without the need of treatment within seven days after the drug withdrawal due to its half-life, but it can persist for several weeks in case of overdosage (1,500mg in a 7 years-old girl) (Zaki S.A. et al, 2009). However, medications are often prescribed to relieve the symptoms (Ward W.Q.…”

Section: Resultsmentioning

confidence: 99%

Psychiatric side effects induced by chloroquine and hydroxychloroquine: a systematic review of case reports and population studies

Talarico

Chakravarty

Liu

et al. 2020

Preprint

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Chloroquine and hydroxychloroquine are commonly used drugs in the treatment of malaria as well as chronic diseases, such as rheumatoid arthritis, and systemic lupus erythematosus. Although various reports on possible psychiatric side effects of these drugs exist, the nature and extent of these effects remain poorly understood. Moreover, the relevance of these drugs in the treatment of early stages of COVID-19 necessitates a careful estimation of their side effects. Here, we provide a systematic review of the psychiatric side effects associated with chloroquine and hydroxychloroquine. We used PubMed, Scopus, and Web of Science platforms to identify relevant literature published between 1962 and 2020. Search terms included chloroquine, hydroxychloroquine, psychiatry, psychosis, depression, anxiety, bipolar disorder, delirium, and psychotic disorders. Only case reports and clinical trials were included. All studies included records of psychiatric side effects induced by either chloroquine or hydroxychloroquine or both. Both retrospective and prospective, randomized as well as non-randomized population studies were included. Overall, the psychiatric side effects are dose- and sex-independent. The most common psychiatric side effects reported are increased speech output/ excessive talking, increased psychomotor activity, irritable mood, auditory hallucinations, delusion of grandiosity, and suicide attempts, likely due to brain intoxicationbe of chloroquine or hydroxychloroquine. The symptoms can develop in a few hours to 11 weeks after drug intake and are normally reversed within a week after the drug withdrawal. We conclude that CQ and HCQ have the potential to induce psychiatric side effects. This study calls for further investigation of psychiatric symptoms induced by these drugs in the short and long term.

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Section: Resultsmentioning

confidence: 99%

Psychiatric side effects induced by chloroquine and hydroxychloroquine: a systematic review of case reports and population studies

Talarico

Chakravarty

Liu

et al. 2020

Preprint

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“… 4 Children with PNS were discovered to have a 36.6–38% probability of concurrent cryptococcal infection, and about 0.3% rate of cryptococcal meningitis (CM). 5 In PNS patients, steroid or immunosuppressive medication results in immunologic dysfunction, which enhances the risk of infection. 6 …”

Section: Introductionmentioning

confidence: 99%

Concomitant of Cryptococcal Meningitis and COVID-19 in a Female Patient with Primary Nephrotic Syndrome and Type 2 Diabetes

Liang,

2024

RMHP

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Background Patients with primary nephrotic syndrome (PNS) are at an increased risk of developing various infections due to the long-term use of immunosuppressive agents. Cryptococcal meningitis (CM) is an uncommon but severe complication that can occur in patients with PNS, particularly those receiving immunosuppressive medications. Case Description This case report describes a middle-aged female patient with PNS and type 2 diabetes mellitus (T2DM) who developed CM. She received a combination regimen of cyclophosphamide and prednisone, achieving partial remission of PNS. However, she later returned to the hospital with high fever and headache. At admission, her nasopharyngeal swab test was positive for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and she received therapy of dexamethasone and favipiravir, but her fever and headache were not improved. Following a lumbar puncture was performed for her and CM was diagnosed based on a positive Cryptococcus culture in the cerebrospinal fluid. The patient’s cyclophosphamides were temporarily discontinued, and antifungal therapy with amphotericin B liposome and fluconazole was initiated. Despite a noticeable increase in her blood glucose levels due to infection during her hospitalization, she showed improvement with intensified glycemic control treatment. The anti-infection showed significant effectiveness, and the patient’s proteinuria remained stable during follow-up. Conclusion The patient with PNS and T2DM was concurrently diagnosed with both CM and coronavirus disease 2019 (COVID-19), marking the first reported case of such co-infections in these patients. Prompt diagnosis and appropriate antifungal therapy are crucial for improved outcomes of PNS patients with CM and COVID-19.

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Cryptococcosis in Patients with Nephrotic Syndrome: A Pooled Analysis of Cases

Fang

Hong

et al. 2017

Mycopathologia

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Cryptococcosis is an infection that may be lethal in patients with nephrotic syndrome (NS). However, there is relatively limited epidemiological and clinical data about cryptococcosis in NS patients. We performed a pooled analysis to systemically summarize the epidemiology, risk factors, clinical and laboratory characteristics, treatments and outcomes of cryptococcosis in NS patients. Using data pooled from our hospital and studies identified via searches of three literature databases, 17 cases were identified for inclusion in this analysis. The prevalence of cryptococcosis in NS was 0.3%, with a higher rate in more recent years. Most patients were Asian (94%) and from upper-middle to high-income countries (76%). The median time interval from NS diagnosis to cryptococcosis diagnosis among the cryptococcosis patients was 16 months, and 46% of the identified cryptococcal infections were diagnosed within the first year of NS diagnosis. Cutaneous cryptococcosis was frequently diagnosed among the included patients (35%), 58% received an erroneous diagnosis and inappropriate treatment, 90% of whom had a cryptococcal infection mistaken for a bacterial infection. The mortality rate was 35%. Standard therapeutic strategies should be emphasized for both antifungal treatment and renal disease control. Further studies conducted in various medical centers are warranted to confirm our conclusions.

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Fulminant intracranial hypertension due to cryptococcal meningitis in a child with nephrotic syndrome

Cited by 7 publications

References 10 publications

Psychiatric side effects induced by chloroquine and hydroxychloroquine: a systematic review of case reports and population studies

Psychiatric side effects induced by chloroquine and hydroxychloroquine: a systematic review of case reports and population studies

Concomitant of Cryptococcal Meningitis and COVID-19 in a Female Patient with Primary Nephrotic Syndrome and Type 2 Diabetes

Cryptococcosis in Patients with Nephrotic Syndrome: A Pooled Analysis of Cases

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