Cryptococcal granulomas in an immunocompromised HIV-negative patient.
Disseminated cryptococcosis usually occurs in immunocompromised individuals with defective cell-mediated immunity, most commonly seen with HIV infection. We present a case of disseminated cryptococcosis in an HIV-negative male patient who presented with headache, fever, altered sensorium of short duration and multiple cutaneous lesions. An emergency CT scan of the head showed multiple intracranial and intraventricular granulomas. Routine laboratory investigations were within the normal range. A CSF examination revealed capsulated yeasts on India ink and a culture yielded cryptococcus neoformans. A cryptococcal antigen test by latex agglutination kit was positive. A biopsy revealed multiple capsulated yeasts cells in the cutaneous lesions, which were consistent with cryptococcus neoformans. The patient was successfully treated with Amphotericin B and Fluconazole with regression of cranial and cutaneous lesions.
Taneja
Juhi
J
Department of Microbiology, GB Pant Hospital, JL Nehru Marg, New Delhi - 110 002, India. drjuhitaneja@gmail.com
Bhargava
Aradhana
A
Loomba
Poonam
P
Dogra
Vinita
V
Thakur
Archana
A
Mishra
Bibhabati
B
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D001927:Brain Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D020314:Central Nervous System Fungal Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D002555:Cerebrospinal Fluid / Q000382:microbiology; D003453:Cryptococcosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D003455:Cryptococcus neoformans / Q000302:isolation & purification*; D003881:Dermatomycoses / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D015725:Fluconazole / Q000627:therapeutic use; D006099:Granuloma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D018023:HIV Seronegativity; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D011859:Radiography; D016896:Treatment Outcome
D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole