Disseminated cryptococcosis presenting with generalized lymphadenopathy

Philip, Kandathil Joseph; Kaur, Rupinder; Mohan, Sangeetha; Masih, Kanwal; Singh, Navjot; Mani, Arun Mathai

doi:10.4103/0970-9371.101175

Cited by 14 publications

(17 citation statements)

References 5 publications

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“…A similar proportion of disseminated cryptococcosis was found between those who had cryptococcosis diagnosis and received antifungal therapy, 20 (69.0%), and those with postmortem diagnosis, 11 (68.75%). The remaining 14 (31.1%) cases presented localized cryptococcal infection of meninges (11) or lung (three) ( Table 2).…”

Section: Methodsmentioning

confidence: 99%

“…Besides, meningeal and respiratory symptoms, fever, weight loss, anemia, lymph-node-enlargement, and hepatosplenomegaly are also observed. [11][12][13][14] The involvement of several organs such as adrenal gland, heart, skin, gut, thyroid gland, and prostate among others have been reported at necropsy studies carried out elsewhere. 6,15 Some reports have shown discrepancies between clinical and postmortem cryptococcosis diagnosis whereas others have pointed out some concerns with the decreasing rate of postmortem examination in teaching hospitals around the world.…”

Section: Introductionmentioning

confidence: 99%

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Cryptococcosis in Acquired Immunodeficiency Syndrome Patients Clinically Confirmed and/or Diagnosed at Necropsy in a Teaching Hospital in Brazil

Torres

Etchebehere

Adad

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Cryptococcosis occurs in acquired immunodeficiency syndrome (AIDS) patients with poor compliance to antiretroviral therapy or unaware of their human immunodeficiency virus status who present severe immunosuppression at admission. Consequently, high mortality rates are observed due to disseminated fungal infection. This report presents clinical and postmortem data of AIDS patients with cryptococcosis in a teaching hospital in Brazil. Retrospectively, medical and necropsy records of AIDS patients with cryptococcosis clinically confirmed and/or postmortem verified were reviewed. Clinical data were compared with those of patients presenting a good outcome to evaluate disseminated fungal infection and the agreement between clinical and postmortem diagnosis. At admission, most of the 45 patients with cryptococcal meningitis who died, presented more altered consciousness (P = 0.0047), intracranial increased pressure (P = 0.047), and severe malnutrition (P = 0.0006) than the survivors. Of 29 (64.4%) patients with cryptococcal meningitis, 23 died before week 2 on antifungal therapy, and the other six during the next 3 months. The remaining 16 (35.6%) cases had other diagnoses and died soon after. At necropsy, 31 (68.9%) presented disseminated infection involving two or more organs, whereas 14 (31.1%) cases had meningeal or pulmonary localized infection. The agreement of 64.4% between clinical and postmortem diagnosis was similar to some studies. However, other reports have shown figures ranging from 34% to 95%. Currently, a progressive worldwide decrease of autopsies is worrying because the role of postmortem examination is pivotal to verify or identify the death causes, which contributes to improve the quality of clinical diagnosis and medical training.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cryptococcosis in Acquired Immunodeficiency Syndrome Patients Clinically Confirmed and/or Diagnosed at Necropsy in a Teaching Hospital in Brazil

Torres

Etchebehere

Adad

et al. 2016

The American Society of Tropical Medicine and Hygiene

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“…Other organs involved in order of decreasing frequency are skin, gastrointestinal tract and bone marrow, with the involvement of lymph nodes found in only few case reports 1 4. Philip et al 5 reported a case with generalised lymphadenopathy, hepatosplenomegaly and miliary patches on chest X-ray while Supparatpinyo6 reported that cryptococcal lymphadenitis presents with involvement of multiple sites. Our case was quite similar to his study, as our patient was also having disseminated cryptococcosis with lymphadenopathy of multiple sites (cervical, axillary, inguinal) along with hepatosplenomegaly and involvement of bone marrow.…”

Section: Discussionmentioning

confidence: 99%

Disseminated cryptococcosis in an immunocompetent child

et al. 2016

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Cryptococcus is a ubiquitous fungus and is known for causing meningitis and cutaneous infections in immunocompromised individuals. Disseminated cryptococcal infection is very rare and almost always found to occur in immunocompromised individuals especially in persons infected with HIV. This is particularly attributed to its capsulated spores. But there are few reported cases in which it has been found to cause disseminated infections even in immunocompetent individuals. We report a similar case of disseminated cryptococcal infection in an immunocompetent host. Early detection and treatment of disseminated cryptococcosis is essential to reduce morbidity and for better outcome.

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“…[1234] C. neoformans commonly affects the lung, meninges, and skin. Lymph node is an unusual site of cryptococcal infection.…”

mentioning

confidence: 99%

“…Lymph node is an unusual site of cryptococcal infection. [1234] Diagnosis of cryptococcal lymphadenitis remains a potential challenge because the disease may be mild or subclinical with lack of characteristic clinical and radiological features. [5] Fine needle aspiration cytology (FNAC) is an easy, rapid, and reliable diagnostic method in cryptococcal lymphadenitis, which helps in the prompt initiation of treatment.…”

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confidence: 99%