Cryptococcus neoformans var. grubii Infection in HIV-Seronegative Patients from Northeast India: Report of Two Cases with Review of Literature

Ahmad

2018

IDCases

With the emergence of Human immunodeficiency virus (HIV) and the resulting immunocompromised state, Cryptococcus neoformans infections have gained more importance in clinical practice. Cryptococcal infections in immunocompetent hosts continue to be uncommon. We present a rare case of Cryptococcus neoformans infective endocarditis (IE) in a young immunocompetent male. As per our literature review, this is the first reported case of native valve Cryptococcus neoformans endocarditis in an immunocompetent host. All cases till date have been reported in patients with underlying immunocompromised state or prosthetic valve.

Section: Discussionmentioning

confidence: 99%

Cryptococcus neoformans infective endocarditis of native valves in an immunocompetent host

Ahmad

2018

IDCases

Gynecol Obstet Res Open J

“…The CD4 count was 379 cells/mm 3 . Urinalysis showed no glucosuria and a trace of protein and a sample was sent for microscopy and culture.…”

Section: Case Reportmentioning

confidence: 99%

“…The disease can occur in HIV sero-negative and sero-positive patients. 3,4 The HIV/AIDS pandemic has assumed global status and the cases that occur need to be reported to raise clinical awareness. Awareness among clinicians is vital to help with early diagnosis, treatment and reduce morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Cryptococcal Meningitis in Pregnancy, the Neglected Diagnosis: A Case Report

Ngwenya¹

2016

Introduction:Cryptococcal meningitis is an opportunistic infection of human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) that can cause maternal and fetal mortality and morbidity. This case report aims to help clinicians to consider it as a differential diagnosis in HIV-seropositive pregnant women presenting with vague symptoms. This is particularly important as HIV/AIDS is now a global pandemic. There is a test available for disease surveillance. Case Report: A 31-year-old P3 G4 HIV seropositive patient on antiretroviral therapy/cotrimoxazole presented at 29 weeks gestation by dates complaining of draining clear fluid per vagina for 24 hours, slight frontal headache and vomiting. On admission, she was ill-looking but was apyrexial with a body temperature of 36.2 °C. A sterile speculum examination confirmed ruptured membranes with a pool of liquor in the posterior vaginal fornix. She was treated as a case of preterm pre-labour rupture of membranes. Therapy consisted of erythromycin and dexamethasone. She complained of increasing frontal headaches and vomiting and on detailed examination was found to be now having neck stiffness. A lumbar puncture was performed and microscopy showed Cryptococcus neoformans. She was managed by a multidisciplinary team involving physicians and was treated with antifungals. She delivered prematurely by normal vaginal delivery a baby boy weighing 2100 g with Apgar 7 and 9 scores at 1 and 5 minutes respectively. Post-partum she continued to fit for a day but subsequently the convulsions stopped and the patient began to improve clinically. Conclusion: There is need to raise awareness amongst clinicians about serious opportunistic infections in HIV infected pregnant mothers for early diagnosis and treatment. Antifungal therapy can be life-saving and prevent maternal deaths.

Ibnosina Journal of Medicine and Biomedical Sciences

“…It is estimated that 223,100 cases of CM cause 181,000 deaths each year among people living with HIV. [5,6] Although there is a marked increase in the incidence of CM around the world due to its association with AIDS, reports concerning this infection in the Arab countries, including Qatar, are limited. [2] The study aimed to estimate the prevalence of CM and describe its clinical profile, laboratory parameters, and outcomes in patients with CM in Qatar.…”

mentioning

confidence: 99%

Cryptococcal meningitis in Qatar: A hospital based study from 2005-2015

Khan

Khattab

Qamar

et al. 2020

Introduction: Cryptococcal meningitis (CM) is an opportunistic and life-threatening infection, affecting mainly patients with AIDS. The aim of this study was to estimate the prevalence of CM and describe its clinical profile, laboratory parameters, and outcomes in patients with CM in Qatar. Patients and Methods: This retrospective study was conducted at Hamad General Hospital. This study includes all patients admitted to the hospital with CM from January 1, 2005, to December 31, 2015. Results: Eleven patients were included in the study, representing 0.01% of the total admissions and 1.1% of all reported meningitis cases during the study; their mean age was 38.5 ± 12 years. Seven patients (63.6%) were males, and most of them were Filipinos. The most frequent presenting symptom was a headache. Six patients (54.5%) were HIV seropositive, three (27.3%) had preexisting immunosuppressive disorders, and two patients (18.2%) had no risk factors. All the patients tested positive in the cerebrospinal fluid (CSF) India ink examination and had a positive CSF culture for Cryptococcus neoformans. All patients received amphotericin B or liposomal amphotericin B with or without 5-flucytosine as induction treatment. Ten patients received fluconazole as consolidation/maintenance therapy. Eight patients (72.7%) were cured at the end of the treatment period. Two patients (18.2%) left before treatment completion, while one patient (9%) died during admission. Conclusions: CM is rare in Qatar and affects both HIV-positive and HIV-negative expatriates. Clinical presentation is nonspecific and requires a high index of suspicion.