title: Pneumonia and pleural effusion due to Cryptococcus laurentii in a clinically proven case of AIDS.
abstract: Non-neoformans cryptococci were previously considered to be saprophytes and nonpathogenic to humans. Cryptococcus laurentii is frequently used as a biological means to control fruit rot. Interestingly, C laurentii has recently been reported to be a rare cause of infection in humans. The authors report a case of pulmonary cryptococcosis caused by C laurentii in a diabetic AIDS patient who was on antituberculosis and antiretroviral treatments. The sputum smear revealed capsulated yeast cells that were identified as C laurentii. Repeated pleural fluid culture revealed growth of C laurentii. Both respiratory samples were negative for acid-fast bacilli. Moraxella catarrhalis and Klebsiella pneumoniae were also found in the sputum, but not in the pleural fluid. The patient had a good response to oral fluconazole therapy at 600 mg/day for five weeks and was then discharged. The present article is the first to report on the rare pulmonary involvement of C laurentii in the Indian HIV population. These unusual forms of cryptococci create a diagnostic predicament in the rapid diagnosis of pulmonary cryptococcosis. A high degree of suspicion and improvement of techniques for culture and identification will contribute to the early diagnosis and treatment of unusual fungal infections.
authors.affiliation: Mycoplasma Laboratory of the Department of Microbiology, Dr ALM PG Institute of Basic Medical Sciences, University of Madras, Chennai, Tamilnadu, India.
authors.forename: Esaki Muthu
authors.initials: EM
authors.lastname: Shankar
authors.forename: Nagalingeswaran
authors.initials: N
authors.lastname: Kumarasamy
authors.forename: Devaleenol
authors.initials: D
authors.lastname: Bella
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Renuka
authors.forename: Hayak
authors.initials: H
authors.lastname: Kownhar
authors.forename: Solomon
authors.initials: S
authors.lastname: Suniti
authors.forename: Ramachandra
authors.initials: R
authors.lastname: Rajan
authors.forename: Usha Anand
authors.initials: UA
authors.lastname: Rao
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000382:microbiology; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D003453:Cryptococcosis / Q000188:drug therapy*; D003454:Cryptococcus / Q000472:pathogenicity*; D003920:Diabetes Mellitus; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D010996:Pleural Effusion / Q000188:drug therapy; D011014:Pneumonia / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D015725:Fluconazole