Fulminant cryptococcal meningoencephalitis after successful treatment of primary cutaneous cryptococcosis

Abstract

Introduction Cryptococcal meningoencephalitis is a life-threatening disease affecting mainly immunocompromised hosts. Case report We present a case of a 64-year-old immunocompetent patient, who initially developed a traumatic scalp skin infection due to Cryptococcus neoformans. The patient received oral fluconazole and subsequently liposomal amphotericin B due to the development of resistance with resolution of the infection. Two years later, during chemotherapy for newly diagnosed gastric and lung cancer, he developed fulminant cryptococcal meningoencephalitis, which did not respond to liposomal amphotericin B and flucytosine. Conclusions To our knowledge, this is the first case of fulminant cryptococcal meningoencephalitis following long latency after adequately treated primary cutaneous infection.

Primary Cutaneous Cryptococcosis in an Elderly Patient: A Case Report and Review of Literature

“…6 Ordanis reported a case of cryptococcal meningitis outbreak due to chemotherapy after the primary disease was cured. 7 The last patient died due to his disease. 8…”

“…6 Ordanis reported a case of cryptococcal meningitis outbreak due to chemotherapy after the primary disease was cured. 7 The last patient died due to his disease. 8 Histopathology findings characteristic of PCC infections are characterized by 2 patterns: a paucireactive pattern or a mixed suppurative pattern.…”

Chronic meningitis by Cryptococcosis gatti in an immunocompetent patient: a case report

“…however, in some cases, the neuroanatomical location may preclude biopsy due to concerns about morbidity or the opportunity to secure a diagnosis by less invasive means. In such cases, it may be preferable to establish the diagnosis of systemic sarcoidosis in the context of a neurological syndrome compatible with NS (probable neurosarcoidosis) [22].…”