[Cryptococcosis in acquired immunodeficiency syndrome (AIDS)]

Area of Science:

• Infectious Diseases
• Mycology
• Neurology

Background:

• Cryptococcus neoformans is an opportunistic pathogen causing severe infections in immunocompromised individuals, notably those with acquired immunodeficiency syndrome (AIDS).
• Cryptococcal meningitis remains a significant cause of morbidity and mortality in patients with advanced HIV infection.

Observation:

• A case study of a 45-year-old patient with HIV infection presenting with a subacute neurological syndrome and fatal outcome.
• Diagnosis was confirmed by isolating Cryptococcus neoformans from cerebrospinal fluid (CSF) and lymph node fine-needle aspiration biopsy.
• Elevated CSF cryptococcal antigen titer (1:2560) was noted.

Findings:

• Treatment involved a six-week course of amphotericin B and 5-fluocytosine.
• Poor prognostic indicators included a positive pre-treatment India ink preparation, high initial CSF antigen titer, low CSF leukocyte count, and extraneural C. neoformans.
• The patient experienced a fatal neurological decline despite treatment.

Implications:

• The case highlights the critical need for early diagnosis of cryptococcosis in patients with AIDS.
• Intensive culture and serologic screening for Cryptococcus neoformans are recommended for all AIDS patients to facilitate earlier detection.
• Timely diagnosis and treatment are essential to improve outcomes and reduce mortality associated with cryptococcal infections in immunocompromised populations.