Delayed diagnosis of cryptococcal meningoencephalitis due to negative cryptococcal antigen test.
Cryptococcus spp. commonly causes infection in immunocompromised hosts. Clinical presentation of cryptococcal meningoencephalitis (CM) is variable, but headache, fever and a high intracranial pressure should suggest the diagnosis. The cryptococcal antigen test is a specific and sensitive rapid test that can be performed on blood or cerebrospinal fluid. We report a case of CM in a patient with previously undetected lymphocytopenia. Because cryptococcal antigen test results were negative, diagnosis and treatment were delayed.
University Clinic for Infectious Diseases, University Hospital Bern, Switzerland. bekessler@bluewin.ch
Bernhard
B
Kessler
Frank
F
Bally
Ekkehard
E
Hewer
Parham
P
Sendi
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D000946:Antigens, Fungal / Q000097:blood* / Q000134:cerebrospinal fluid*; D003453:Cryptococcosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003455:Cryptococcus neoformans / Q000276:immunology / Q000302:isolation & purification*; D057210:Delayed Diagnosis; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008231:Lymphopenia / Q000150:complications; D008590:Meningoencephalitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*
D000935:Antifungal Agents; D000946:Antigens, Fungal