title: Cryptococcal meningitis presenting as sinusitis in a renal transplant recipient.
abstract: Cryptococcal meningitis is a relatively common invasive fungal infection in immunocompromised patients, especially in solid organ transplant recipients. Clinical presentation typically includes fever, headache, photophobia, neck stiffness, and/or altered mental status. Unusual presentations may delay diagnosis. Therapy is challenging in renal transplant patients because of the nephrotoxicity associated with amphotericin B, the recommended treatment. We present a case of cryptococcal meningitis in a renal transplant recipient presenting as acute sinusitis with successful treatment using fluconazole as primary therapy.
authors.affiliation: Department of Medicine, St. John's Medical Center, Detroit, Michigan, USA.
authors.forename: S P
authors.initials: SP
authors.lastname: Iyer
authors.forename: K
authors.initials: K
authors.lastname: Movva
authors.forename: M
authors.initials: M
authors.lastname: Wiebel
authors.forename: P
authors.initials: P
authors.lastname: Chandrasekar
authors.forename: G
authors.initials: G
authors.lastname: Alangaden
authors.forename: M
authors.initials: M
authors.lastname: Carron
authors.forename: P
authors.initials: P
authors.lastname: Tranchida
authors.forename: S G
authors.initials: SG
authors.lastname: Revankar
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D003455:Cryptococcus neoformans / Q000187:drug effects / Q000276:immunology / Q000302:isolation & purification*; D003937:Diagnosis, Differential; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation / Q000009:adverse effects*; D016919:Meningitis, Cryptococcal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008875:Middle Aged; D012852:Sinusitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole
keywords: Cryptococcus; meningitis; renal transplantation; sinusitis