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Cryptococcal meningo-encephalitis after prolonged corticosteroid therapy
J G Koeleman1, C Rustemeijer, P W Wijermans
1Department of Clinical Microbiology, Free University Hospital, Amsterdam.
Abstract:
We present a case of a 69-yr-old woman who developed cryptococcal meningo-encephalitis after 9 yr of corticosteroid therapy. The diagnosis was made on an India ink preparation and positive culture of the cerebrospinal fluid sediment. NMR-imaging was a useful tool for detecting intracerebral localisation of the infection. The patient was successfully treated with amphotericin B and flucytosine for 6 wk and with itraconazole for another 8 wk.
Insights
A 69-year-old woman developed cryptococcal meningoencephalitis after long-term corticosteroid use. Early diagnosis via cerebrospinal fluid analysis and successful treatment with antifungal medications highlight key management strategies.
Area of Science:
- Neuroscience
- Infectious Diseases
- Pharmacology
Background:
- Long-term corticosteroid therapy can predispose individuals to opportunistic infections.
- Cryptococcal meningoencephalitis is a serious central nervous system infection.
Observation:
- A 69-year-old woman on corticosteroids for 9 years presented with symptoms of meningoencephalitis.
- Diagnosis was confirmed by India ink preparation and cerebrospinal fluid culture.
Findings:
- Nuclear Magnetic Resonance (NMR) imaging effectively identified intracranial lesions.
- The patient responded well to a combination therapy including amphotericin B, flucytosine, and itraconazole.
Implications:
- This case underscores the importance of vigilance for opportunistic infections in immunocompromised patients.
- Effective diagnostic and therapeutic strategies are crucial for managing cryptococcal meningoencephalitis.