Cryptococcal Lymphadenitis and Massive Splenomegaly in an Immunocompromised Patient

Coskun, Zafer Unsal; Mathews, Dana; Weatherall, Paul T.; Skiest, Daniel J.; Öz, Orhan K.

doi:10.1097/01.rlu.0000257201.95620.ba

Cited by 6 publications

(7 citation statements)

References 12 publications

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“…In addition, it is critical to identify HL and cryptococcal lymphadenitis in patients with cryptococcal meningitis accompanied by multiple lymph node enlargements. The most common sites of Cryptococcus infection are the CNS and the lungs ( 20 ). However, many reports ( 20 – 22 ) have demonstrated that Cryptococcus can infect the lymph nodes and lead to cryptococcal lymphadenitis, of which the clinical manifestations are very similar to lymphoma, including lymph node enlargements in the neck, supraclavicular region, mediastinum, and groin as well as splenomegaly.…”

Section: Discussionmentioning

confidence: 99%

“…The most common sites of Cryptococcus infection are the CNS and the lungs ( 20 ). However, many reports ( 20 – 22 ) have demonstrated that Cryptococcus can infect the lymph nodes and lead to cryptococcal lymphadenitis, of which the clinical manifestations are very similar to lymphoma, including lymph node enlargements in the neck, supraclavicular region, mediastinum, and groin as well as splenomegaly. Biopsy is the gold standard to distinguish these two diseases ( 21 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

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Case Report: Cryptococcal eosinophilic meningitis in a patient with Hodgkin lymphoma

Zhang

Li²,

Shen³

et al. 2022

Front. Neurol.

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Cryptococcal meningitis is the most common fungal meningitis in clinical practice. It primarily occurs in immunocompromised people and is typically associated with human immunodeficiency virus (HIV) infection. In rare cases, it is associated with Hodgkin lymphoma (HL). Eosinophilic meningitis (EM) is characterized by increased eosinophils in the cerebrospinal fluid (CSF) and is often caused by a parasitic infection of the central nervous system (CNS). EM caused by cryptococcal infection is rare; only four cases have been reported in the past 30 years. Here, we report a case of cryptococcal meningitis in a patient with HL who presented with an atypical eosinophil-predominant CSF cytology response. The patient's eosinophil proportion reached 91%; a proportion this high has not been reported previously and may be associated with HL. After antifungal therapy and tumor chemotherapy, the proportion of eosinophils decreased significantly. This case shows that cryptococcal meningitis and HL may be simultaneously contributing to CSF eosinophilia. HL should be considered in patients with eosinophilic cryptococcal meningitis and multiple adenopathies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case Report: Cryptococcal eosinophilic meningitis in a patient with Hodgkin lymphoma

Zhang

Li²,

Shen³

et al. 2022

Front. Neurol.

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“…Cryptococcal infections have also been reported to produce marked splenomegaly and mild hepatomegaly [86,91].…”

Section: Organomegalymentioning

confidence: 98%

“…Enlarged lymph nodes with or without central or diffuse low attenuation are seen in the majority of patients with abdominal histoplasmosis [86,[91][92][93]. Cryptococcal infection has also been noted to have enlarged lymph nodes on CT imaging.…”

Section: Lymphadenopathymentioning

confidence: 99%

Diagnostic Radiology

Hospenthal

Carswell

2015

Diagnosis and Treatment of Fungal Infections

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“…1,2 The infection starts in the respiratory tract but secondarily involves the central nervous system, lungs, skin, lymph nodes, bone marrow, gastrointestinal tract, retina, liver, spleen and other parts of the body. [3][4][5][6] Although there have been several reported cases of cryptococcal lymphadenitis, [7][8][9][10][11][12][13] lymph node involvement by Cryptococcus is not a common manifestation in AIDS patients as compared to other infections. 8 Therefore, a prompt diagnosis is mandatory in such situations for early initiation of treatment.…”

mentioning

confidence: 99%