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Fungaemia due to Cryptococcus laurentii as a complication of immunosuppressive therapy--a case report

K Furman-Kuklińska1, B Naumnik, M Myśliwiec

  • 1Department of Nephrology and Transplantation with Dialysis Unit, Medical University of Bialystok, Białystok, Poland. karolinafurman@op.pl

Advances in Medical Sciences
|June 2, 2009
PubMed

Insights

Cryptococcus laurentii, a non-neoformans cryptococcus, can cause fungemia in immunocompromised individuals. Itraconazole may be effective when fluconazole fails, highlighting the need for updated treatment guidelines for this emerging fungal pathogen.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Immunocompromised Host Research

Background:

  • Cryptococcus laurentii, once considered a non-pathogenic saprophyte, is increasingly recognized as a cause of opportunistic infections.
  • Diminished immunity creates favorable conditions for Cryptococcus laurentii to act as a significant pathogen.

Observation:

  • A case of fungemia caused by Cryptococcus laurentii in a young male with membranoproliferative glomerulonephritis undergoing aggressive immunosuppressive therapy is presented.
  • The patient exhibited persistent septic fever and positive blood cultures despite 3 weeks of fluconazole treatment.
  • An abdominal CT scan revealed an inflammatory focus near the right lobe of the liver, suggesting a potential mycotic origin.

Findings:

  • The patient was switched to itraconazole therapy due to persistent symptoms and positive cultures.
  • Negative microbiological blood tests were achieved after 5 weeks of itraconazole treatment.
  • This case adds to the limited evidence supporting itraconazole's efficacy in treating Cryptococcus laurentii fungemia, with only one prior report.

Implications:

  • The findings underscore the potential pathogenicity of Cryptococcus laurentii in immunocompromised hosts.
  • There is a critical need for updated clinical guidelines regarding the early diagnosis, treatment, and prophylaxis of infections caused by non-neoformans cryptococci.
  • Developing effective strategies is crucial to protect vulnerable populations from these emerging fungal threats.

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