Cryptococcal meningitis in non-HIV-infected patients

Shih, Chung Ching; Chen, Y C; Chang, Shan‐Chwen; Luh, Kwen‐Tay; Hsieh, Wen-Shyong

doi:10.1093/qjmed/93.4.245

Cited by 123 publications

(104 citation statements)

References 25 publications

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“…HIV-uninfected patients with cryptococcal meningitis due to C. neoformans usually have some other comorbidity present that is associated with immunosuppression (1,8,11,13,26,39,44,47,49). Occasionally, disease occurs in patients without any clear underlying immune deficit or predisposing condition.…”

mentioning

confidence: 99%

Most Cases of Cryptococcal Meningitis in HIV-Uninfected Patients in Vietnam Are Due to a Distinct Amplified Fragment Length Polymorphism-Defined Cluster of Cryptococcus neoformans var. grubii VN1

et al. 2011

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mentioning

confidence: 99%

Most Cases of Cryptococcal Meningitis in HIV-Uninfected Patients in Vietnam Are Due to a Distinct Amplified Fragment Length Polymorphism-Defined Cluster of Cryptococcus neoformans var. grubii VN1

et al. 2011

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“…A study has reported that approximately 60% of headache presentation in patients with AIDS headache is due to cryptococcal meningitis or presumed bacterial sinusitis (Shih et al, 2000).…”

Section: Resultsmentioning

confidence: 99%

“…Patient described in this case had a rare etiology of a common presentation to ED. Classic meningitic findings, such as neck rigidity, are absent in 75% of cases The most common presentation of cryptococcosis is a subacute meningitis or meningoencephalitis with fever, malaise and headache (Shih et al, 2000). Visual changes have been reported and most of visual changes in HIV infected patients are attributable to Cryptococcus meningitis (Hong et al, 2007), as well as new onset seizure activity.…”

Section: Resultsmentioning

confidence: 99%

A 28 Years Old Woman with Severe Headache and Few Episodes of Vomiting: A Case Report

Nakhayi¹

2010

American Journal of Infectious Diseases

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Problem statement: Cryptococcosis neoformans is commonest central nervous system infection in individuals infected with HIV. Most of the patients infected with Cryptococcus neoformans present with headache and visual changes. Approach: A 28 year old woman presented to Emergency Department (ED) with a chief complaint of headache, fever and vomiting and developed seizures during the first hour of admission. Firstly, diagnosed as cryptococcal meningitis, then, because of having a low White Blood Cell count (WBC) and low Total Lymphocyte Count (TLC) she was checked for HIV Ab and P24 Ag. Results: A diagnosis of HIV was made then her family members were checked for HIV and they were also HIV positive. Patient was discharged with a two month course of Fluconazole and after completion of antifungal treatment, Antiretroviral Treatment (HAART) was started. Conclusion: This case indicated that Cryptococcosis neoformans may develop in Immune-deficient patients, so complete laboratory workup and high index of suspicion to HIV should be under diagnosis.

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“…Our patient was immunocompetent with negative HIV test, unremarkable immunoglobulins and no history of cancer and developed cryptococcal meningitis. In tropical areas, mortality rate ranges from 0% to 38% in non-HIV patients [10]. There are some factors associated with increased mortality such as advanced age (over 60 years) and chronic organ failure [11].…”

Section: Discussionmentioning

confidence: 99%

Central Nervous System Cryptococcosis in Non-Immunosuppressed Patient

Lopez-Rivera¹,

Cintrón-Colón²,

Rivera³

et al. 2017

J Med Cases

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Cryptococcus is a fungus related to bird droppings (especially pigeons). It is described as an opportunistic pathogen. The leading defense against this fungus is the T-cell immunity, reason why it is related to immunocompromised patients (human immunodeficiency virus (HIV), organ transplant patients among others). The annual incidence is 0.4 -1.3 per 100,000. The central nervous system (CNS) involvement is the most common manifestation in an immunocompromised patient; conversely it is a very uncommon manifestation in non-immunocompromised patients. A 32-year-old Hispanic male patient with no medical history, heterosexual and no toxics habits visited our institution, after visiting three emergency rooms for 1 week, complaining of general malaise, constant non-throbbing holocephalic headache 4/10 and low-grade fever of 12 days of evolution. Labs were unremarkable and vital signs showed fever of 38.6 °C. Physical exam was remarkable for neck stiffness. Patient was admitted with suspected meningitis. HIV test was negative and lumbar puncture showed increased opening pressure and India ink stain was positive. Patient was managed successfully with fluconazole. CNS cryptococcosis in non-immunosuppressed patients is extremely unusual. Diagnosis could be delayed because of low suspicious index in healthy population. Most experts recommend amphotericin B combined with flucytosine. Our patient was managed successfully with fluconazole IV followed with oral fluconazole. Patients from countries where flucytosine is unavailable and cannot tolerate amphotericin B can benefit from fluconazole.

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Cryptococcal meningitis in non-HIV-infected patients

Abstract: Pulmonary cryptococcosis associated with cryptococcal meningitis in non-HIV infected patients is an uncommon finding. We report a case of polymyositis who developed pulmonary cryptococcosis and cryptococcal meningitis while she was on long term oral steroids, treated successfully.

Cited by 123 publications

References 25 publications

Most Cases of Cryptococcal Meningitis in HIV-Uninfected Patients in Vietnam Are Due to a Distinct Amplified Fragment Length Polymorphism-Defined Cluster of Cryptococcus neoformans var. grubii VN1

Most Cases of Cryptococcal Meningitis in HIV-Uninfected Patients in Vietnam Are Due to a Distinct Amplified Fragment Length Polymorphism-Defined Cluster of Cryptococcus neoformans var. grubii VN1

A 28 Years Old Woman with Severe Headache and Few Episodes of Vomiting: A Case Report

Central Nervous System Cryptococcosis in Non-Immunosuppressed Patient

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