Cryptococcal lymphadenitis-First presentation in an HIV-positive patient.
1Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Summary
A rare case of cervical cryptococcal lymphadenitis, a fungal infection, presented as the first sign of secondary immunodeficiency in an HIV-positive patient. Diagnosis was confirmed via fine needle aspiration cytology and laboratory tests.
Area of Science:
- Infectious Diseases
- Immunology
- Mycology
Background:
- Cryptococcal infection is a severe opportunistic infection, particularly in individuals with human immunodeficiency virus (HIV).
- Typically, it affects the respiratory system, with potential secondary spread to the central nervous system, skin, and lymph nodes.
- Secondary immunodeficiency predisposes individuals to opportunistic infections like cryptococcosis.
Observation:
- A rare case of isolated cervical cryptococcal lymphadenitis was observed.
- The lymphadenitis was diagnosed using fine needle aspiration cytology.
- This presentation was the initial indicator of underlying secondary immunodeficiency in the patient.
Findings:
- Fine needle aspiration cytology confirmed isolated cervical cryptococcal lymphadenitis.
- Diagnostic tests including Periodic acid-Schiff stain, India ink preparation, and fungal culture verified the presence of Cryptococcus.
- Subsequent investigations revealed the patient was HIV-positive, establishing the diagnosis of secondary immunodeficiency.
Implications:
- This case highlights the importance of considering cryptococcal lymphadenitis in the differential diagnosis of cervical lymphadenopathy, especially in immunocompromised individuals.
- Fine needle aspiration cytology can be a crucial tool for the early diagnosis of rare presentations of cryptococcosis.
- Early diagnosis of opportunistic infections like cryptococcosis is vital for initiating timely antiretroviral therapy and antifungal treatment in HIV-positive patients.
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