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First case of mixed infection with Cryptococcus deuterogattii and Cryptococcus neoformans VNI in an Ivorian
Fulgence K Kassi1, Virginie Bellet2, Adama Doumbia3
1Université Félix Houphouët Boigny, UFR Pharmacie, Laboratoire de Parasitologie et Mycologie - CeDReS (Centre de Diagnostic et de Recherche sur le SIDA et les autres maladies infectieuses), CHU de Treichville, BP V3, Abidjan, Cote d'Ivoire; UMI 233 IRD-UM-INSERM U1175 Laboratoire de Parasitologie et Mycologie médicale UFR Pharmacie, 15 Av. C. Flahault, BP 14491, 34093 Montpellier Cedex 5, France.
Introduction:
Cryptococcal meningitis (CM) may be caused by several species of Cryptococcus.
Case Presentation:
We describe a fatal case of CM in a HIV-positive patient from Ivory Coast infected by Cryptococcus neoformans VNI and Cryptococcusdeuterogattii. Isolates were recovered from cerebrospinal fluid (CSF) prior to systemic antifungal treatment. Six isolates were studied (the entire culture plus five isolated colonies from it). Serotyping was performed via LAC 1 and CAP 64 gene amplification. Genotyping was performed using restriction fragment length polymorphism (RFLP) analysis of the URA5 gene, (GACA)4, (GTG)5 and M13 PCR fingerprinting. URA5-RFLP analysis identified the original culture with two different molecular type combinations. However, URA5-RFLP profiles of the five colonies isolated from the original sample revealed two different species. Four colonies were identified as C.deuterogattii and the last isolate as C.neoformans VNI. The in vitro susceptibility profile was determined using the standard method according to the CLSI M27-A3 protocol. The isolates were susceptible to the tested antifungals (fluconazole, flucytosine and amphotericin B). Treatment with fluconazole (1200 mg day-1) was initiated; however, the patient died 17 days after the onset of antifungal therapy.
Conclusion:
This is the first reported case of mixed infection with C. neoformans and C.deuterogattii in a HIV-positive patient.
Insights
This case study reports a fatal cryptococcal meningitis (CM) in an HIV-positive patient coinfected with Cryptococcus neoformans and Cryptococcus deuterogattii. Despite antifungal susceptibility, the patient did not survive.
Area of Science:
- Medical Mycology
- Infectious Diseases
- HIV/AIDS Research
Background:
- Cryptococcal meningitis (CM) is a serious fungal infection caused by various *Cryptococcus* species.
- HIV-positive individuals are particularly vulnerable to invasive cryptococcosis.
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