title: Cryptococcemia in an HIV-negative patient with decompensated liver cirrhosis.
abstract: BACKGROUND
  Cryptococcal infections have been mostly associated with immunocompromised individuals, 80-90% of whom have been HIV-positive patients. Increasingly, cryptococcal infections are being reported in cirrhotic patients who are HIV-negative. The underlying immunologic defects in cirrhotic patients seem to play an important role in predisposing them to cryptococcosis and affecting their morbidity and mortality.
  
  
  METHODS
  We present a case of disseminated cryptococcosis in an HIV-negative patient with underlying cirrhosis, who had rapid worsening of his hyponatremia with renal failure and was unable to recover, despite aggressive measures.
  
  
  CONCLUSIONS
  Cryptococcus is a more common culprit of infections seen in cirrhotic patients than what it was previously known, and a high index of suspicion is required to diagnose these patients. Identification of poor prognostic factors, early diagnosis and intervention is crucial in the management of these patients.
authors.affiliation: Division of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA; manasakandula14@gmail.com.
authors.forename: Manasa
authors.initials: M
authors.lastname: Kandula
authors.affiliation: Division of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.
authors.forename: Amar H
authors.initials: AH
authors.lastname: Kelkar
authors.affiliation: Division of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Liberio
authors.affiliation: Division of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.
authors.forename: Meenakshy K
authors.initials: MK
authors.lastname: Aiyer
keywords: Cryptococcus; HIV-negative; cirrhosis; cryptococcemia; decompensated liver cirrhosis; disseminated cryptococcosis; fungal infections