title: Spontaneous cryptococcal peritonitis with fungemia in patients with decompensated cirrhosis: Report of two cases.
abstract: Cryptococcus neoformans is encapsulated yeast that predominately infects immunocompromised individuals. Liver disease is an under-recognized predisposition for cryptococcal disease. We report two nonalcoholic, nondiabetic, and human immunodeficiency virus - negative cirrhotic patients, with spontaneous cryptococcal peritonitis. Cryptococcus infection was diagnosed by culture of ascitic fluid and peripheral blood in both. We treated the first patient with amphotericin-B, but he expired. The second patient with earlier diagnosis, survived to discharge with fluconazole treatment. We suggest a high clinical suspicion for Cryptococcus as a possible etiology of spontaneous peritonitis in cirrhotic patients.
authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Chinmaya Kumar
authors.initials: CK
authors.lastname: Bal
authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Vikram
authors.initials: V
authors.lastname: Bhatia
authors.affiliation: Department of Microbiology, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Khillan
authors.affiliation: Department of Microbiology, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Neha
authors.initials: N
authors.lastname: Rathor
authors.affiliation: Department of Critical Care Medicine, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Saini
authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Ripu
authors.initials: R
authors.lastname: Daman
authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Shiv Kumar
authors.initials: SK
authors.lastname: Sarin
keywords: Cirrhosis; Cryptococcus neoformans; India ink staining; spontaneous bacterial peritonitis; spontaneous cryptococcal peritonitis