Fulminant cryptococcal meningoencephalitis after successful treatment of primary cutaneous cryptococcosis.

Iordanis Romiopoulos, Zoi Dorothea Pana, Athina Pyrpasopoulou, Ioanna Linardou, Eugenia Avdelidi, Maria Sidiropoulou, Eleni Chatzidrosou, Dimitrios Ioannides, Asterios Karagiannis, Emmanuel Roilides
Author Information
  1. Iordanis Romiopoulos: MD, Infectious Diseases Unit, Hippokration Hospital, 54642 Thessaloniki, Greece.
  2. Zoi Dorothea Pana: MD, PhD, Infectious Diseases Unit, Hippokration Hospital, 54642 Thessaloniki, Greece.
  3. Athina Pyrpasopoulou: MD, PhD, Infectious Diseases Unit, 2 Propedeutic Dept of Internal Medicine, Hippokration Hospital, 54642 Thessaloniki, Greece.
  4. Ioanna Linardou: MD, 2 Propedeutic Dept of Internal Medicine, Hippokration Hospital, 54642 Thessaloniki, Greece.
  5. Eugenia Avdelidi: MD, Neurology Dept, Hippokration Hospital, 54642 Thessaloniki, Greece.
  6. Maria Sidiropoulou: MD, Radiology Dept, Hippokration Hospital, 54642 Thessaloniki, Greece.
  7. Eleni Chatzidrosou: MD, Microbiology Dept, Hippokration Hospital, 54642 Thessaloniki, Greece.
  8. Dimitrios Ioannides: MD, PhD, A' Dept for Skin and Venereal Diseases, Hippokration Hospital, 54642 Thessaloniki, Greece.
  9. Asterios Karagiannis: MD, PhD, 2 Propedeutic Dept of Internal Medicine, Hippokration Hospital, 54642 Thessaloniki, Greece.
  10. Emmanuel Roilides: MD, PhD, Infectious Diseases Unit, Hippokration Hospital, 54642 Thessaloniki, Greece.

Abstract

INTRODUCTION: cryptococcal meningoencephalitis is a life-threatening disease affecting mainly immunocompromised hosts.
CASE REPORT: We present a case of a 64-year-old immunocompetent patient, who initially developed a traumatic scalp skin infection due to . The patient received oral fluconazole and subsequently liposomal amphotericin B due to the development of resistance with resolution of the infection. Two years later, during chemotherapy for newly diagnosed gastric and lung cancer, he developed fulminant cryptococcal meningoencephalitis, which did not respond to liposomal amphotericin B and flucytosine.
CONCLUSIONS: To our knowledge, this is the first case of fulminant cryptococcal meningoencephalitis following long latency after adequately treated primary cutaneous infection.

Keywords

References

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Word Cloud

Created with Highcharts 10.0.0meningoencephalitisinfectioncryptococcalcasepatientdevelopedskindueliposomalamphotericinBfulminantprimarycutaneousINTRODUCTION:Cryptococcallife-threateningdiseaseaffectingmainlyimmunocompromisedhostsCASEREPORT:present64-year-oldimmunocompetentinitiallytraumaticscalpreceivedoralfluconazolesubsequentlydevelopmentresistanceresolutionTwoyearslaterchemotherapynewlydiagnosedgastriclungcancerrespondflucytosineCONCLUSIONS:knowledgefirstfollowinglonglatencyadequatelytreatedFulminantsuccessfultreatmentcryptococcosisCryptococcusmeningitis

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