Abdominal Lymphonodular Cryptococcosis in an Immunocompetent Child

Zaidi, Mehjabeen; Qureshi, Sonia; Shakoor, Sadia; Fatima, Saira; Mir, Fatima

doi:10.1155/2015/347403

Cited by 2 publications

(4 citation statements)

References 19 publications

(23 reference statements)

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“…However, in our study, nearly 67.3% of patients had abdominal lymph nodes invasion, including of the mesentery, hepatic portal, and abdominal para-aortic lymph nodes, and some of them were accompanied with calcification, which is rarely reported [27]. Several cases presented with abdominal pain or discomfort were misdiagnosed as tuberculosis because abdominal cryptococcosis has similar symptoms or pathologic results as tuberculosis.…”

Section: Discussionmentioning

confidence: 62%

“…Besides lung and brain invasion, Dromer [ 26 ] demonstrated that the incidence of abdominal, renal, lymph node, and skin invasion (1.2%, 1.9%, 1.7%, and 0.4%, respectively) were lower than the results of the present study. However, in our study, nearly 67.3% of patients had abdominal lymph nodes invasion, including of the mesentery, hepatic portal, and abdominal para-aortic lymph nodes, and some of them were accompanied with calcification, which is rarely reported [ 27 ]. Several cases presented with abdominal pain or discomfort were misdiagnosed as tuberculosis because abdominal cryptococcosis has similar symptoms or pathologic results as tuberculosis.…”

Section: Discussionmentioning

confidence: 82%

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Clinical characteristics of disseminated cryptococcosis in previously healthy children in China

Gao

Jiao

et al. 2017

BMC Infect Dis

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BackgroundDisseminated cryptococcosis is a rare and fatal disease, and limited data exist regarding it in children. This study aimed to investigate the clinical characteristics of disseminated cryptococcosis in previously healthy children in China.MethodsHospitalized patients with disseminated cryptococcosis were enrolled during January 1996 to December 2015 in Beijing Children’s Hospital, Capital Medical University, China. Data on clinical manifestations, laboratory tests, treatment, and prognosis were evaluated.ResultsA total of 52 pediatric patients with no underlying disease were enrolled, including 38 boys and 14 girls. Only 10 cases had a history of exposure to pigeon droppings. Fever, cough, and hepatomegaly were 3 main manifestations of disseminated cryptococcosis. However, headache was more common in patients with central nervous system (CNS) invasion than in patients with non-CNS invasion (P < 0.05). Lung (96.2%, 50/52) was the most commonly invaded organ, but only 9.6% (5/52) of patients had respiratory signs. The most common findings on chest imaging were hilar or mediastinal lymphadenopathy (46.8%, 22/47), and nodules (44.7%, 21/47), including small nodules in a scattered distribution (57.1%, 12/21) or miliary distribution (42.9%, 9/25), especially localized in subpleural area. Subsequent invasion occurred in the CNS, abdomen lymph nodes, liver, spleen, peripheral lymph nodes, and skin. In all patients, 42.3% (22/52) and 51.9% (27/52) had elevated eosinophils or IgE, respectively. The positive rate of serum cryptococcal antigen was higher, especially in patients with CNS invasion (approximately 83.3%), than with other primary methods used for pathogen detection, including cerebrospinal fluid (CSF) cryptococcal antigen, cultures of blood, bone marrow, or CSF, and CSF ink staining. The overall mortality rate of pediatric patients in our study was 11.5% (6/52). Some cases had long-term sequela, including hydrocephalus, cirrhosis, or blindness.ConclusionsDisseminated cryptococcosis can occur in previously healthy or immunocompetent children in China. Lung and CNS were most commonly invaded by this disease. Furthermore, most cases usually showed no obvious or specific symptoms or signs, and therefore pediatricians should pay more careful attention to identify this disease.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 82%

Clinical characteristics of disseminated cryptococcosis in previously healthy children in China

Gao

Jiao

et al. 2017

BMC Infect Dis

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“…Cough is also a reported symptom in pulmonary cryptococcal infection [15] . Similarly, radiological finding like abdominal lymphadenopathy, pulmonary cavitation, pleural effusion in active TB infection are nonspecific and have been reported in disseminated cryptococcal infection [16] . This implies that highly sensitive and specific diagnostic tests are required to rule out active TB in this high-risk population.…”

Section: Discussionmentioning

confidence: 78%

“…Moreover, a definitive microbiological TB diagnosis in patients with advanced HIV-associated cryptococcal meningitis patients is challenging. The most common form of TB in advanced HIV is extra-pulmonary TB; including abdominal, pleural, genitourinary and central nervous system [16] , [17] . With the exception of Tuberculous meningitis, other forms of extra pulmonary TB often require a tissue diagnosis, which may be challenging to obtain in resource poor settings.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis preventive therapy (TPT) to prevent tuberculosis co-infection among adults with HIV-associated cryptococcal meningitis: A clinician’s perspective

Kasibante

Rutakingirwa

Kagimu

et al. 2020

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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As part of the END TB strategy, the World Health organization (WHO) recommends provision of tuberculosis preventive therapy (TPT) to all people at high risk of developing active TB disease. Patients with HIV-associated cryptococcal meningitis are severely immunocompromised and therefore should be eligible for TPT. In this commentary we discuss the challenges associated with starting tuberculosis preventive therapy in patients with HIV associated cryptococcal meningitis in a clinical setting, we highlight the benefit, existing gaps and research opportunities of tuberculosis preventive therapy in this patient population.

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Abdominal Lymphonodular Cryptococcosis in an Immunocompetent Child

Cited by 2 publications

References 19 publications

Clinical characteristics of disseminated cryptococcosis in previously healthy children in China

Clinical characteristics of disseminated cryptococcosis in previously healthy children in China

Tuberculosis preventive therapy (TPT) to prevent tuberculosis co-infection among adults with HIV-associated cryptococcal meningitis: A clinician’s perspective

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