title: Disseminated Cryptococcosis in an HIV-negative patient in South Africa: the elusive differential diagnosis.
abstract: The presence of an opportunistic infection in a patient in sub-Saharan Africa is assumed to be due to underlying immunosuppression from human immunodeficiency virus (HIV) infection. The presence of disseminated cryptococcosis in a non-HIV-infected patient is interesting as it is unique in our setting because the majority of infections are found in HIV-infected individuals. The protean manifestations of the disease and its predilection for immunosuppressed patients make cryptococcosis a challenging and elusive disease to diagnose in HIV-negative patients in our setting, especially due to limited resources. We present a case of disseminated cryptococcosis in an immunocompetent patient and discuss diagnostic and therapeutic features in this subset of patients.
authors.affiliation: Department of Internal Medicine, Tygerberg Hospital, University of Stellenbosch, Cape Town, South Africa. momitha@telkomsa.net
authors.forename: Mohammed
authors.initials: M
authors.lastname: Mitha
authors.forename: Preneshni
authors.initials: P
authors.lastname: Naicker
authors.forename: Prakash
authors.initials: P
authors.lastname: Mahida
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced; D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage / Q000009:adverse effects; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D003453:Cryptococcosis / Q000175:diagnosis* / Q000382:microbiology; D003455:Cryptococcus neoformans / Q000302:isolation & purification*; D003937:Diagnosis, Differential; D015725:Fluconazole / Q000008:administration & dosage; D006801:Humans; D008297:Male; D013019:South Africa; D014057:Tomography, X-Ray Computed
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole