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Asymptomatic Meningitis and Lung Cavity in a Case of Cryptococcosis

Aixin Li1, Qunhui Li1, Caiping Guo1

  • 1Department of Infectious Diseases, Capital Medical University Affiliated Beijing You An Hospital, Beijing Institute of Hepatology, Beijing, China (mainland).

The American Journal of Case Reports
|October 27, 2017
PubMed

Insights

Disseminated cryptococcosis in an HIV-1 patient presented atypically, with skin lesions as the main symptom and unusual cerebrospinal fluid and lung imaging results. This case highlights the importance of considering cryptococcosis even with non-classic presentations for timely diagnosis.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Immunocompromised Hosts

Background:

  • Cryptococcus neoformans (C. neoformans) is a significant opportunistic pathogen, particularly in individuals with Acquired Immunodeficiency Syndrome (AIDS).
  • Typical C. neoformans infections manifest in the central nervous system (CNS) and/or lungs.
  • Prompt diagnosis and treatment are crucial for managing cryptococcosis in immunocompromised patients.

Observation:

  • A case report details a 52-year-old male with Human Immunodeficiency Virus type 1 (HIV-1) infection presenting with disseminated cryptococcosis.
  • The patient's chief complaint was a cutaneous (skin) lesion, with concurrent subacute meningitis and pulmonary involvement.
  • Cerebrospinal fluid (CSF) analysis and lung computed tomography (CT) scans showed atypical findings for cryptococcosis.

Findings:

  • Disseminated cryptococcosis can present with varied clinical manifestations, not always conforming to typical patterns.
  • Cutaneous lesions can be the primary presenting symptom in disseminated cryptococcosis.
  • Atypical results in CSF and lung imaging necessitate a broader differential diagnosis.

Implications:

  • This case underscores the need for heightened clinical suspicion for C. neoformans infection in HIV-1 patients, even with unusual symptoms.
  • Diagnostic procedures should be carefully considered, especially when initial test results are atypical.
  • Recognizing diverse presentations of cryptococcosis aids clinicians in achieving earlier and more accurate diagnoses, improving patient outcomes.

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