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Addison's disease due to adrenal insufficiency in an immunocompetent patient with disseminated cryptococcosis. Case report.

Systemic mycoses, such as cryptococcosis, mainly affect the lungs and central nervous system; however, involvement of other organs, such as the adrenal glands, is rare. This has been described in some cases of primary adrenal insufficiency (PAI) of fungal origin, which are associated with high mortality. We present the case of a 65-year-old immunocompetent man who presented clinical manifestations of adrenal insufficiency. Biochemical tests confirmed PAI, and abdominal tomography revealed hyperplasia of both adrenal glands, predominantly on the left side. Left adrenalectomy was performed, and …

Successful desensitization to liposomal amphotericin B for the treatment of disseminated cryptococcosis in pregnancy: a case report.

BACKGROUND: Cryptococcosis is the most common opportunistic fungal infection in people with human immunodeficiency virus. On a global scale, it causes 15% of acquired immunodeficiency syndrome-related mortality. CASE SUMMARY: We report the case of a 21-year-old cisgender pregnant woman living with human immunodeficiency virus who presented with headache and photophobia. Her clinical course was complicated by recurrent hospital admissions for disseminated cryptococcosis and a life-threatening reaction to liposomal amphotericin B, the mainstay of treatment. A desensitization protocol was implem…

A fatal case of pulmonary cryptococcosis in an apparently immunocompetent patient from Cote D' Ivoire.

Cryptococcosis is an opportunistic mycosis caused by Cryptococcus, mainly affecting the immunocompromised. We report a case of pulmonary cryptococcosis within a 31-year-old immunocompetent patient admitted for painful chest swelling evolving for 4 months prior to admission. The chest X-Ray showed a rounded pulmonary opacity. The chest ultrasound revealed a pulmonary abscess diffusing under the skin. Direct examination using the Indian ink and the May-Grunwald Giemsa staining revealed encapsulated yeasts in the pus. The Culture of the pus on the Sabouraud medium with chloramphenicol confirmed t…

Longitudinally Extensive Transverse Myelitis and Vasculitis by Cryptococcosis in a Non-HIV Patient: A Case Report.

INTRODUCTION: Cryptococcosis is a fungal infection with frequent involvement of the central nervous system, particularly in patients immunocompromised by the human immunodeficiency virus (HIV). Its essential neurological presentation is meningoencephalitis, with exceptional spinal cord involvement. We present the case of an immunocompetent patient with myelitis and vasculitis caused by Cryptococcus. CLINICAL CASE: A 59-year-old male patient with diabetes mellitus presented with 2 weeks of lower limb weakness, vertigo, and urinary retention with subsequent loss of alertness. Magnetic resonance…

CNS Aspergillosis and Cryptococcosis with Cytomegalovirus Pneumonia in a Patient with Chronic Lymphocytic Leukemia Treated with Acalabrutinib.

Bruton's tyrosine kinase inhibitors (BTKis) are the preferred treatment for chronic lymphocytic leukemia (CLL). Despite their therapeutic benefits, these targeted agents have been associated with an increased risk of invasive infections. We describe a 68-year-old male who developed multiple bacterial, fungal and viral infections while on treatment with acalabrutinib. To our knowledge, this is the first reported case of concomitant CNS infections with Cryptococcus neoformans and Aspergillus fumigatus, along with cytomegalovirus (CMV) and herpes simplex virus type 1 (HSV-1) pneumonia while on ac

Связанный с финолимодом криптококковый хороидит и опасный криптококкоз в случае повторного излучаемого множественным склерозом.

Мужчина в 20-х, у которого зародился релапсирующий множественный склероз, развил спинной криптококкоз и хороидит после 8 лет терапии с пероральным иммуномодулирующим финголимодом. Криптококкоз был диагностирован с помощью позвоночной биопсии после того, как в результате обычного двухлетнего нейроимации были случайно выявлены радиологические изменения в позвоночнике С5. Впоследствии он был принят для прохождения внутривенной антифунгальной терапии. Во время госпитализации пациент сообщил о двусторонних поплавках и впоследствии обнаружил двусторонние хромоидальные повреждения, указывающие на час

Совпадение в аннотации оригинала
A man in his 20s with a background of relapsing-remitting multiple sclerosis developed spinal cryptococcosis and choroiditis after 8 years of therapy with the oral immunomodulator fingolimod. The osseous cryptococcosis was diagnosed with a vertebral biopsy, after radiological changes in the C5 vertebra were incidentally identified during routine biannual neu…

Pulmonary cryptococcosis misdiagnosed as lung cancer in a man with normal immune function: A case report.

Pulmonary cryptococcosis is an opportunistic infection of cryptococcus both in immunocompetent and immunocompromised patients, who suffered from HIV infection, organ transplantation, diabetes mellitus, corticosteroid or immunosuppressive therapy, and malignancy. Pulmonary cryptococcosis is the commonest location of non-central nervous system cryptococcosis and usually presents with nonspecific symptoms. It often shows shadows on the lung, which makes it difficult to distinguish it from lung cancer. Here we report a case of a 52-year-old man with pulmonary cryptococcosis, who was misdiagnosed a…

Screening for Cryptococcal Antigenemia and Burden of Cryptococcosis at the Time of HIV Diagnosis: A Retrospective Multicenter Study.

INTRODUCTION: Screening for cryptococcal antigen (CrAg) is recommended for people living with HIV (PLWH) who present with low CD4 lymphocyte … ed to early CrAg testing (adjusted hazard ratio 2.028, 95% CI 1.109-3.708). CONCLUSIONS: Burden of cryptococcosis remained high among PLWH with low CD4 lymphocyte counts in Taiwan. Uptake of CrAg screening among late HIV presenters was still suboptimal and delayed. Late CrAg testing was associated with a higher mortality.

Evaluation of the Dynamiker Cryptococcal Antigen Lateral Flow Assay for the Diagnosis of HIV-Associated Cryptococcosis.

Cryptococcal meningitis is a leading cause of meningitis in sub-Saharan Africa. Given the need for rapid point-of-care testing, we evaluated the diagnostic performance of the Dynamiker cryptococcal antigen (CrAg) lateral flow assay (LFA). We assessed the diagnostic performance of the Dynamiker CrAg LFA compared to the IMMY CrAg LFA as the reference standard. We tested 150 serum, 115 plasma, and 100 cerebrospinal fluid (CSF) samples from HIV patients with symptomatic meningitis and 113 serum samples from patients with suspected asymptomatic cryptococcal antigenemia. Compared to the IMMY CrAg LF

Cryptococcosis in patients with liver cirrhosis: Death risk factors and predictive value of prognostic models.

BACKGROUND: Liver cirrhosis is associated with immune deficiency, which causes these patients to be susceptible to various infections, including cryptococcus infection. Mortality in cirrhotic patients with cryptococcosis has increased. The present study was to explore the risk factors of mortality and the predictive ability of different prognostic models. METHODS: Forty-seven cirrhotic patients with cryptococcosis at a tertiary care hospital were included in this retrospective study. Data on demographics, clinical parameters, laboratory exams, diagnostic methods, medication during hospitaliza…

A Spuriously Negative Cryptococcal Antigen Assay Result in Disseminated Cryptococcosis: the Deception of the Postzone Phenomenon.

Cryptococcus is a basidiomycetous yeast responsible for considerable HIV-related morbidity and mortality. A cachectic 26-year-old HIV-positive man with a CD4 count of 103 cells/μl presented with fever, breathlessness, and bilateral lower limb weakness. A brain computed tomography scan could not elucidate the neurological deficit. His blood was sent for culture and serum cryptococcal antigen detection, with the latter testing as negative. By the fourth day of admission, the patient's condition had deteriorated drastically. A lumbar puncture was performed, and like his serum sample, the cerebros

Sjögren's syndrome with nervous system injury combined with pulmonary and osseous cryptococcosis: a case report.

BACKGROUND: Sjögren's syndrome is a common autoimmune disease that can involve the nervous system, but rarely both the central and periphera … with the diagnosis of Sjögren's syndrome with nervous system injury combined pulmonary and osseous cryptococcosis. She took a reduced dose of prednisone about 10 mg/day, terminated mycophenolate mofetil, and began to take immunoglobulin of 0.4 g/kg/day intravenously for 5 days, fluconazole (400 mg/day) for 6 months. Within 3 weeks, her chest radiography showed …

Comparing immunochromatography with latex antigen agglutination testing for the diagnosis of cryptococcosis in cats, dogs and koalas.

Although the point-of-care cryptococcal antigen lateral flow assay (LFA) has revolutionized the diagnosis of cryptococcosis in human patients, to date there has been no large-scale examination of this test in animals. We therefore assessed the LFA in cats, dogs and koalas suspected of having cryptococcosis. In sum, 528 serum specimens (129 from cats, 108 from dogs, 291 from koalas) were tested using the LFA and one of two commercially available latex cryptococcal antigen agglutination test (LCAT) kits. The LCAT is a proven and well-accepted method in veterinary patients and therefore taken as …

CARD9 Is Required for Classical Macrophage Activation and the Induction of Protective Immunity against Pulmonary Cryptococcosis.

Caspase recruitment domain-containing protein 9 (CARD9) is a critical adaptor molecule triggered by the interaction of C-type lectin receptors (CLRs) with carbohydrate motifs found in fungi. Consequently, clinical and animal studies indicate that CARD9 is an important regulator of protective immunity against fungal pathogens. Previous studies suggest that CARD9 is important for the induction of protection against Cryptococcus neoformans, an opportunistic fungal pathogen that causes life-threatening infections of the central nervous system in immunocompromised patients. However, the effect of C

Endobronchial Valves for the Treatment of Bronchopleural Fistula and Pneumothorax Caused by Pulmonary Cryptococcosis in an AIDS Patient.

Cryptococcal disease is an opportunistic infection that occurs primarily among people with advanced HIV disease and is an important cause of morbidity and mortality. Spontaneous pneumothorax (SP) is rare in acquired immune deficiency syndrome (AIDS) patients with pulmonary cryptococcosis (PC), but when it occurs, rapid and effective treatment is crucial to the prognosis, with mortality rates varying from 30 to 60%. SP is related to pneumonia mainly due to bacterial infections and pneumocystic jirovecii pneumonia (PJP). However, SP caused by PC is rare. When it occurs, it is often fatal and ref…

Mediastinal cryptococcosis simulating thyroid neoplasia in immunocompetent patient with prior diagnosis and treatment for COPD.

We report a case of mediastinal cryptococcosis with thyroid invasion in a patient who presented dry cough and persistent dyspnea. This patient has been treated for COPD, presenting no clinical responses. Spirometry showed fixed flattening of inspiratory and expiratory loops, suggesting extrinsic tracheal compression. A freezing biopsy revealed a mass consisting of lymph nodes and yeasts with characteristics of Cryptococcus spp. After surgical resection of the lesion, the patient was treated with fluconazole, showing total remission of the disease and symptomatology.

[Meningeal cryptococcosis in patients non infected with HIV: presentation of two cases and review of the literature].

Cryptococcosis is a fungal disease of global distribution with a higher incidence in developing countries, where it represents one of the main causes of meningitis, associated with high morbidity and mortality. It mainly occurs in patients with immunosuppression (due to HIV infection, glucocorticoid treatment, transplants, cancer, etc.). However, in recent years there has been an increase in cases in immunocompetent, which is as serious or more severe than in immunocompromised. We report two cases of cryptococcal meningitis. A 48-year-old male with no pathological history, in whom HIV infectio…

Disseminated Cryptococcosis With Severe Increased Intracranial Pressure Complicated With Cranial Nerve Palsy in a Child.

Cryptococcosis is less common in children than in adults but remains an important cause of pneumonia and meningoencephalitis in both immunocompromised and immunocompetent patients. Intracranial hypertension commonly complicates cryptococcal meningitis and may cause significant visual and neurologic morbidity and mortality. Early and aggressive management of intracranial hypertension in accordance with established guidelines reduces the risk of long-term complications and death. In this case report, we present a 12-year-old girl with cryptococcal meningitis, pneumonitis and dermatitis complicat…

RAPIDLY PROGRESSIVE PULMONARY CRYPTOCOCCOSIS WITH CAVITATION IN AN IMMUNOCOMPETENT WOMAN: A CASE REPORT AND LITERATURE REVIEW.

Pulmonary cryptococcosis with pulmonary cavitation is rare, especially in immunocompetent cryptococcosis patients. We describe here a case of rapidly progressive pulmonary with cavitation in an immunocompetent woman. A 29-year-old woman had a routine chest X-ray as part of a routine examination. The chest X-ray showed pulmonary nodules. She was diagnosed as having bacterial pneumonia even though she had no symptoms and was treated with ampicillin orally. A chest X-ray was repeated 12 days later as follow-up which showed an increase in the nodules. She continued to be asymptomatic and had a nor…