Cryptococcus neoformans Peritonitis in a Patient with Alcoholic Cirrhosis: Case Report and Review of the Literature

Abstract

In the absence of coexisting HIV infection Cryptococcus neoformans is rarely considered in the differential diagnosis of peritonitis that occurs in patients with cirrhosis and ascites. Here, we report on a 39-year-old male, HIV-negative patient with decompensated alcohol toxic liver cirrhosis who developed a lethal intraperitoneal infection with C. neoformans. We reviewed the literature and found an additional 19 cases with culture confirmed cryptococcal peritonitis in combination with liver disease or AIDS. We suggest that awareness of this unusual but lethal entity may lead to earlier diagnosis and proper treatment.

Cryptococcal Peritonitis in A Patient with Liver Cirrhosis: Case Report

“…[8] In 50% of the cases the process is said to be transudative which is also seen in our case. [7] CONCLUSIONS We concluded in this study that spontaneous cryptococcal peritonitis in a patient with disseminated disease is a rare manifestation of C. neoformans infection. Grave prognosis is associated in cases where cryptococcosis is present with liver cirrhosis as seen in this case.…”

“…[4][5][6][7] Cryptococcal peritonitis is seen in 7.4% of HIV cases, 2% in non HIV cases.CP is considered a rare manifestation of cryptococcosis in cirrhosis [8] . In a stud, it was found that among 33 HIV-negative patients with disseminated disease, cirrhosis was present most commonly and was also associated with grave prognosis.…”

Cryptococcosis

“…Bone marrow infiltration can be observed in severely immunocompromised hosts. Cryptococcal peritonitis [21] and cryptococcuria are also reported in several case series. Any organ of the human body can be a site of cryptococcal infections.…”

Case Report of Cryptococcus Albidus Peritonitis in a Peritoneal Dialysis Patient and a Review of the Literature

“…The mainstays of fungal peritonitis management are rapid peritoneal fluid exchanges to minimize gross turbidity and the risk of adhesions, early removal of the catheter, and concurrent parenteral antifungal treatment (24). In C. neoformans peritonitis, amphotericin B is the antifungal agent of choice, followed by oral fluconazole (26,31), which is known to achieve a peritoneal penetration of more than 60% (24). There are additionally 2 cases in the literature of C. laurentii peritonitis, both of which occurred in patients on PD (32).…”