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Updated: Jan 26, 2026

Macrophage Cholesterol Depletion and Its Effect on the Phagocytosis of Cryptococcus neoformans
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Macrophage Cholesterol Depletion and Its Effect on the Phagocytosis of Cryptococcus neoformans

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Disseminated Cryptococcus neoformans infection in a left ventricular assist device recipient

Deeksha Jandhyala1,2, Eugene M Tan2, David Cook Stahr3

  • 1Internal Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.

BMJ Case Reports
|April 11, 2019
PubMed

Insights

A patient with severe heart disease developed a rare fungal infection, Cryptococcus neoformans, after complex cardiac support. Early antifungal treatment and lifelong suppression were crucial for managing this opportunistic infection.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Critical Care Medicine

Background:

  • A 51-year-old male with coronary artery disease and dyslipidemia experienced acute myocardial infarction leading to cardiogenic shock.
  • The patient required advanced life support, including intra-aortic balloon pump and extracorporeal membrane oxygenation (ECMO).
  • Hospital course complicated by Pseudomonas aeruginosa bloodstream infection and suspected infected right atrial thrombus.

Observation:

  • Developed acute hypoxic respiratory distress with new pulmonary infiltrates on day 100 of admission.
  • Sputum and blood cultures confirmed Cryptococcus neoformans infection.
  • Elevated cryptococcal serum antigen (1:20) and normal cerebrospinal fluid studies.

Findings:

  • Successful treatment of Cryptococcus neoformans infection with 2 weeks of combination antifungal therapy.
  • Initiation of lifelong fluconazole suppression for long-term management.
  • Demonstrates a rare opportunistic fungal infection in an immunocompromised cardiac patient.

Implications:

  • Highlights the risk of opportunistic infections in critically ill patients with advanced cardiac support.
  • Emphasizes the importance of vigilant monitoring for fungal infections in prolonged intensive care unit stays.
  • Underscores the need for tailored antifungal strategies in complex cardiac cases.

Keywords:
cardiovascular medicinecryptococcosiscryptococcusheart failureinfectious diseases

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