Cryptococcal meningitis in an immunocompetent child: a case report and literature review.
An immunocompetent 5 year-old girl presented with pyrexia of unknown origin associated with headache. Initial investigations showed leukocytosis and an increased erythrocyte sedimentation rate. A Widal-Weil Felix test, blood film for malarial parasites, mycoplasma IgM antibody, cultures from blood and urine, full blood picture, Mantoux test, and chest x-ray were all negative. A lumbar puncture was done as part of a work-up for pyrexia of unknown origin. Cryptococcus neoformans was seen on India ink examination and confirmed on culture. She was treated with 10 weeks of intravenous amphotericin B and 8 weeks of fluconazole. Further immunological tests did not reveal any defect in the cell-mediated immune system. C. neoformans meningitis may present with non-specific symptoms and should be considered in a work-up for pyrexia of unknown origin.
Othman
Norlijah
N
Department of Human Growth and Development, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia. nor@medic.upm.edu.my
Abdullah
Nor Atiqah Ng
NA
Wahab
Zubaidah Abdul
ZA
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002675:Child, Preschool; D003455:Cryptococcus neoformans / Q000302:isolation & purification / Q000472:pathogenicity; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D008296:Malaysia; D016919:Meningitis, Cryptococcal / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*
D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole