title: Disseminated cryptococcosis with meningitis, peritonitis, and cryptococcemia in a HIV-negative patient with cirrhosis: a case report.
abstract: BACKGROUND
  Cryptococcus neoformans is an encapsulated yeast that causes serious infections in immunocompromised populations. The majority of cases occur in HIV-infected individuals. Disseminated disease is uncommon, and very rarely includes peritonitis.
  
  
  METHODS
  We report a case of a 41-year-old, HIV-negative, Caucasian man with alcoholic liver cirrhosis who presented with fever and seizure. Disseminated cryptococcosis with meningitis, peritonitis, and cryptococcemia was diagnosed, and despite adequate treatment the patient developed multi-system organ failure and eventually expired.
  
  
  CONCLUSIONS
  Disseminated cryptococcosis, particularly with peritonitis, is an uncommon manifestation of Cryptococcus neoformans infection. Liver cirrhosis serves as a risk factor for disseminated disease in HIV-negative patients. A high clinical suspicion and early initiation of therapy is needed to recognize and treat patients effectively.
authors: Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 9020, Baltimore, Maryland, USA. byehia@jhmi.edu
authors: Baligh Ramzi
authors: BR
authors: Yehia
authors: Michael
authors: M
authors: Eberlein
authors: Stephen D
authors: SD
authors: Sisson
authors: David N
authors: DN
authors: Hager