Cryptococcal meningitis in a patient with chronic hepatitis C treated with pegylated-interferon and ribavirin.
Various adverse events have been reported during combination therapy with pegylated (PEG)-interferon-α and ribavirin, although opportunistic infections, especially cryptococcal meningitis, are very rare. A 61-year-old woman complained of headaches and a fever during treatment of a chronic hepatitis C virus (HCV) infection. She had been treated for 7 months. Her headaches were refractory to analgesics, and she developed subtle nuchal rigidity. The cerebral spinal fluid (CSF) revealed a white blood cell count of 205/mm(3), 51 mg/dL protein, 35 mg/dL glucose, and negative Cryptococcus antigen. The CSF culture resulted in no growth. Five days later, the CSF was positive for Cryptococcus antigen. We administered amphotericin B and flucytosine, followed by fluconazole. Approximately 2 months later, she was discharged. For the first time, we report a case of cryptococcal meningitis during the treatment of chronic HCV with PEG-interferon-α and ribavirin.
Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
Tae-Hee
TH
Lee
Department of Neurology, Konyang University College of Medicine, Daejeon, Korea.
Kee-Ook
KO
Lee
Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
Yong-Seok
YS
Kim
Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
Sun-Moon
SM
Kim
Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
Kyu-Chan
KC
Huh
Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
Young-Woo
YW
Choi
Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
Young-Woo
YW
Kang
D000935:Antifungal Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000009:adverse effects*; D003455:Cryptococcus neoformans / Q000276:immunology / Q000472:pathogenicity*; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects*; D016919:Meningitis, Cryptococcal / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D011092:Polyethylene Glycols / Q000009:adverse effects*; D011994:Recombinant Proteins / Q000009:adverse effects; D012254:Ribavirin / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
D000935:Antifungal Agents; D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b
Cryptococcus; Hepatitis C; Meningitis; PEG-interferon-α; Ribavirin