title: Rapid respiratory deterioration and sudden death due to disseminated cryptococcosis in a patient with the acquired immunodeficiency syndrome.
abstract: We report the case of a patient with the acquired immunodeficiency syndrome (AIDS) whose death occurred within 30 hours of hospitalization due to disseminated cryptococcosis, manifested by dizziness, cough, and shortness of breath. The clinical picture was consistent with pneumocystis pneumonia, and antibiotic therapy with corticosteroids was initiated. Despite initial improvement, the patient's condition quickly worsened, resulting in cardiorespiratory arrest and death. Autopsy revealed cryptococci in several organs. Sudden, rapid deterioration and death are rare consequences of disseminated cryptococcosis, and steroids may worsen the course of the disease. On the basis of this case and review of similar cases in the literature, we recommend early consideration of disseminated cryptococcosis in AIDS patients with pneumonia. Early diagnosis and appropriate therapy are essential to reduce morbidity and mortality.
authors.affiliation: Department of Medicine, University of Mississippi Medical Center, Jackson 39216, USA.
authors.forename: S
authors.initials: S
authors.lastname: Penmetsa
authors.forename: T A
authors.initials: TA
authors.lastname: Rose
authors.forename: E D
authors.initials: ED
authors.lastname: Crook
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D000328:Adult; D003453:Cryptococcosis / Q000175:diagnosis* / Q000188:drug therapy; D003645:Death, Sudden; D003937:Diagnosis, Differential; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis; D008297:Male; D011014:Pneumonia / Q000188:drug therapy / Q000382:microbiology*; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis
chemical_list: D005938:Glucocorticoids