Disseminated cryptococcosis in an apparently immunocompetent patient presenting with primary intraventricular haemorrhage.
Disseminated cryptococcosis is uncommon and almost always occurs in HIV-infected patients. However, cryptococcosis can also be found in patients of organ transplantation, in those on disease modifying agents for rheumatological conditions and in patients with underlying immunodeficiency. Cryptococcal infection may occur in an immunocompetent patient, but the pathogenic strain is usually Cryptococcus gattii, and not C. neoformans. However, disseminated disease, especially cerebral involvement in the form of primary intraventricular haemorrhage, is exceedingly rare. We report a case of disseminated cryptococcosis with cutaneous, cerebral and bone marrow involvement in an HIV-negative, apparently immunocompetent patient. Although the patient did not have the usual immunocompromising diseases, there were clinical signs possibly indicating a weakened immune system. This report highlights the need for awareness of disseminated cryptococcosis among patients with no apparent immunocompromising conditions.
Department of General Medicine, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India.
Partha
P
Pal
Department of Endocrinology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India.
Sayantan
S
Ray
Department of Pathology, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India.
Sisir Kumar
SK
Patra
Department of General Medicine, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India.
Debabrata
D
Mukherjee
D000293:Adolescent; D000935:Antifungal Agents / Q000627:therapeutic use; D001855:Bone Marrow Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D002543:Cerebral Hemorrhage / Q000209:etiology*; D003453:Cryptococcosis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D056285:Cryptococcus gattii; D003881:Dermatomycoses / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D007121:Immunocompetence; D008297:Male; D016919:Meningitis, Cryptococcal / Q000175:diagnosis / Q000188:drug therapy
D000935:Antifungal Agents