Cryptococcal peritonitis: report of a case and review of the literature.
We describe a patient diagnosed with AIDS and cirrhosis who had recently suffered a self-limited and non-specific esophageal ulceration. After this, he was hospitalized because of an oral bleeding with fatal evolution, and Cryptococcus neoformans was isolated from ascitic fluid during a routine paracenteses. We have reviewed the literature and, since 1963, only another 10 cases of cryptococcal peritonitis have been reported. A liver disease and not the AIDS (surprisingly, our case is the only report of cryptococcal peritonitis in a subject having both diseases) was the most common underlying disease (72.7%) and was associated with the worst prognosis (only one patient survived). An oral or upper gastrointestinal bleeding was the most common associated circumstance although recent steroid or antibiotic therapy has been also reported. Finally, diagnosis was delayed in many patients. The reasons for these delays are discussed.
Stiefel
P
P
Department of Internal Medicine, Hospital Universitario Virgen del Rocio, Seville, Spain. stiefel@cica.es
Pamies
E
E
Miranda
M L
ML
Martin-Sanz
M V
MV
Fernandez-Moyano
A
A
Villar
J
J
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis*; D000328:Adult; D001202:Ascitic Fluid / Q000382:microbiology; D003453:Cryptococcosis / Q000175:diagnosis*; D003455:Cryptococcus neoformans / Q000302:isolation & purification; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D016469:Fungemia / Q000175:diagnosis; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis; D008297:Male; D010538:Peritonitis / Q000175:diagnosis*