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Macrophage Cholesterol Depletion and Its Effect on the Phagocytosis of Cryptococcus neoformans
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Overwhelming cryptococcosis complicated by cryptococcal endocarditis

Wiaam Elkhatib1, Joshua Y Kwon2, Michael B Phillips2

  • 1Internal Medicine, Mayo Clinic Hospital, Jacksonville, Florida, USA wiaamelkhatib@hotmail.com.

BMJ Case Reports
|March 3, 2022
PubMed

Insights

This case report details a rare instance of cryptococcal endocarditis in an immunocompromised patient. Prompt diagnosis and antifungal therapy were crucial for management, highlighting the importance of treating underlying conditions.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Hematology

Background:

  • Cryptococcal species endocarditis is a rare and often fatal condition.
  • It typically affects immunocompromised individuals or those with prosthetic heart valves.

Observation:

  • A 70-year-old man with recent hospitalizations and septic tank exposure presented with fever, weakness, and encephalopathy.
  • Diagnosis revealed cryptococcal species on blood, native aortic valve endocarditis, and meningitis.
  • Cerebrospinal fluid analysis indicated lymphocytosis secondary to chronic lymphocytic leukemia.

Findings:

  • The patient had native aortic valve endocarditis caused by cryptococcal species.
  • Management involved antifungal therapy due to surgical contraindication.
  • Underlying chronic lymphocytic leukemia was identified as the immunocompromising state.

Implications:

  • This case underscores the importance of considering rare fungal infections in immunocompromised patients with cardiac and neurological symptoms.
  • Effective management requires prompt diagnosis, appropriate antifungal therapy, and addressing the underlying cause of immunosuppression.
  • Further research into cryptococcal endocarditis is needed due to its infrequent documentation and high mortality.
Keywords:
chronic myeloid leukemiacryptococcosiscryptococcusinfectionsvalvar diseases

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