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Published on: July 24, 2016
Fatal neurocryptococcosis in a Colombian underage patient
Maria Clara Noguera1, Patricia Escandón2, Merle Arévalo3
1Grupo Caribe de Enfermedades Infecciosas, Universidad Metropolitana, Barranquilla, Colombia. maclarnog@gmail.com.
Abstract:
Cryptococcosis is a life-threatening mycosis reported mainly in human adults with low frequency in children. High mortality rates may occur in cases with late diagnosis therefore, a timely suspicion of this pathology is important. Cryptococcus gattii is the less prevalent species complex predominantly isolated from apparently normal hosts. We report a fatal case of neurocryptococcosis in a Colombian minor without known risk factors, in Barranquilla, Colombia. The patient was hospitalized for neurological assessment with a recent history of intense headache, vomiting, anorexia, loss of consciousness, drowsiness, inability to recognize family members, disorientation, aphasia and anxiety. Despite initiating antifungal treatment after isolation of the fungus from cerebrospinal fluid (CSF), the patient died early due to his deteriorated condition.
Insights
Cryptococcosis, a fungal infection, can be fatal in children, especially with delayed diagnosis. This case highlights a rare fatal neurocryptococcosis in a Colombian child, emphasizing the need for early suspicion and treatment.
Area of Science:
- Mycology
- Infectious Diseases
- Pediatrics
Background:
- Cryptococcosis is a serious fungal infection, typically affecting adults, with rare occurrences in children.
- Early diagnosis and treatment are crucial to prevent high mortality rates associated with this mycosis.
- Cryptococcus gattii, a less common species complex, is often found in individuals without apparent risk factors.
Observation:
- A fatal case of neurocryptococcosis occurred in a Colombian child in Barranquilla.
- The child presented with severe neurological symptoms including headache, vomiting, loss of consciousness, disorientation, and aphasia.
- The patient had no previously known risk factors for the infection.
Findings:
- The causative agent was identified as Cryptococcus gattii, isolated from cerebrospinal fluid.
- Despite prompt antifungal treatment initiation post-diagnosis, the patient's condition rapidly deteriorated.
- The case resulted in an early fatality due to the severity of the neuroinfection.
Implications:
- This case underscores the importance of considering cryptococcosis in pediatric neurological emergencies, even without typical risk factors.
- Timely suspicion and diagnosis of neurocryptococcosis in children are critical for improving outcomes.
- Further research into pediatric cryptococcosis, particularly with Cryptococcus gattii, is warranted to understand its presentation and management.
