Pneumonia and pleural effusion due to Cryptococcus laurentii in a clinically proven case of AIDS.
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.
Shankar
Esaki Muthu
EM
Mycoplasma Laboratory of the Department of Microbiology, Dr ALM PG Institute of Basic Medical Sciences, University of Madras, Chennai, Tamilnadu, India.
Kumarasamy
Nagalingeswaran
N
Bella
Devaleenol
D
Renuka
Srinivasan
S
Kownhar
Hayak
H
Suniti
Solomon
S
Rajan
Ramachandra
R
Rao
Usha Anand
UA
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
D015725:Fluconazole