TY - JOUR
T1 - Cryptococcal meningoencephalitis in an immunodeficiency virus positive patient coinfected with tuberculosis
AU - Wirantara, Hendy
AU - Rusli, Musofa
AU - Arfijanto, Muhammad Vitanata
AU - Bramantono,
N1 - Publisher Copyright:
© 2023, Sanglah General Hospital. All rights reserved.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - Background: Cryptococcal meningitis is an inflammation of the meninges due to Cryptococcus fungal infection which commonly invades people living with immunodeficiency virus (PLHIV) with impaired immunity. The disease has a high mortality rate and is frequently misdiagnosed in the early stages due to vague symptoms. This case report aimed to provide information regarding diagnosing and managing cryptococcal meningoencephalitis in patients with acquired immunodeficiency syndrome (AIDS) and tuberculosis. Case presentation: We reported a case of 34-year-old woman that complained of headache and fever from one month ago. There were also oral white patches in the last two weeks. The patient was diagnosed with lung TB and human immunodeficiency virus (HIV) in February 2021, but the TB was just being treated in the past two months and HIV in last two weeks. Head CT-scan with contrast showed meningoencephalitis, brain edema, left frontal, left ethmoidal, left and right maxillary and left sphenoid sinusitis. On the 9th day of hospitalization, the patient had seizures. Analysis of the cerebrospinal fluid culture revealed Cryptococcus neoformans. The patient’s comorbidities were leucopenia, hypoalbuminemia, pneumonia, brain edema which led to poor prognosis. On the 10th day, the seizures relapsed, followed by the drastically reduced SpO2 and death. Septic shock and multiorgan failure were considered the cause of the case’s death. Conclusion: This case highlights the importance of early diagnosis and management to avoid unfavorable outcome.
AB - Background: Cryptococcal meningitis is an inflammation of the meninges due to Cryptococcus fungal infection which commonly invades people living with immunodeficiency virus (PLHIV) with impaired immunity. The disease has a high mortality rate and is frequently misdiagnosed in the early stages due to vague symptoms. This case report aimed to provide information regarding diagnosing and managing cryptococcal meningoencephalitis in patients with acquired immunodeficiency syndrome (AIDS) and tuberculosis. Case presentation: We reported a case of 34-year-old woman that complained of headache and fever from one month ago. There were also oral white patches in the last two weeks. The patient was diagnosed with lung TB and human immunodeficiency virus (HIV) in February 2021, but the TB was just being treated in the past two months and HIV in last two weeks. Head CT-scan with contrast showed meningoencephalitis, brain edema, left frontal, left ethmoidal, left and right maxillary and left sphenoid sinusitis. On the 9th day of hospitalization, the patient had seizures. Analysis of the cerebrospinal fluid culture revealed Cryptococcus neoformans. The patient’s comorbidities were leucopenia, hypoalbuminemia, pneumonia, brain edema which led to poor prognosis. On the 10th day, the seizures relapsed, followed by the drastically reduced SpO2 and death. Septic shock and multiorgan failure were considered the cause of the case’s death. Conclusion: This case highlights the importance of early diagnosis and management to avoid unfavorable outcome.
KW - Cryptococcus neoformans
KW - human immunodeficiency virus
KW - meningoencephalitis
KW - tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=85169681772&partnerID=8YFLogxK
U2 - 10.15562/bmj.v12i2.4180
DO - 10.15562/bmj.v12i2.4180
M3 - Article
AN - SCOPUS:85169681772
SN - 2089-1180
VL - 12
SP - 1490
EP - 1496
JO - Bali Medical Journal
JF - Bali Medical Journal
IS - 2
ER -