title: Treatment-resistant depression prior to the diagnosis of cryptococcal meningitis: a case report.
abstract: Comorbidity of chronic infectious disorders is one of the common causes of treatment-resistant depression. Depression may alter some aspects of immunity that can contribute to the development of infection. Here we describe an elderly male with treatment-resistant depression. Ten months after antidepressants were administered, he was found to have cryptococcal meningitis. After successful treatment of the central nervous system infection, his depressive symptoms improved apparently. A possible interaction between depression and cellular immunity was discussed. Physicians should be cautious about the risk of opportunistic infection in patients with depression, especially in immunocompromised condition.
authors.affiliation: Department of Psychiatry, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Ker-Li
authors.initials: KL
authors.lastname: Hsueh
authors.forename: Pao-Yen
authors.initials: PY
authors.lastname: Lin
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001284:Atrophy; D001921:Brain / Q000473:pathology; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy* / Q000276:immunology / Q000523:psychology; D003937:Diagnosis, Differential; D004351:Drug Resistance; D005500:Follow-Up Studies; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D008279:Magnetic Resonance Imaging; D008297:Male; D016919:Meningitis, Cryptococcal / Q000175:diagnosis* / Q000276:immunology / Q000523:psychology* / Q000628:therapy; D008803:Mianserin / Q000031:analogs & derivatives / Q000627:therapeutic use; D000078785:Mirtazapine
chemical_list: D000928:Antidepressive Agents; D008803:Mianserin; D000078785:Mirtazapine