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Progressive Encephalopathy With New Pulmonary Opacities in an Immunocompromised Host
Marika Orlov1, Andrew T Pham1, Dan Merrick1
1Department of Pulmonary Sciences and Critical Care Medicine (M. O., T. M., and A. K.), the Department of Medicine (A. T. P.), the Department of Pathology (D. M.), the Department of Radiology (M. W.), University of Colorado Anschutz Medical Campus, Aurora, CO; and the Department of Infectious Diseases (S. S.), University of Nebraska Medical Center, Omaha, NE.
An immunosuppressed kidney transplant recipient developed progressive neurological symptoms after travel to Mexico. This case highlights a rare fungal infection mimicking meningitis in immunocompromised patients.
Area of Science:
- Infectious Diseases
- Nephrology
- Neurology
Background:
- A 48-year-old male kidney transplant recipient on immunosuppressants presented with a month of neurological symptoms.
- Symptoms included headache, fatigue, word-finding difficulties, and night sweats, with recent travel to central Mexico.
- Previous treatment for presumed meningitis was ineffective.
Purpose of the Study:
- To report a case of a rare fungal infection in an immunosuppressed patient.
- To discuss the diagnostic challenges and clinical presentation of this infection.
Main Methods:
- Case report detailing patient history, clinical presentation, and laboratory findings.
- Review of diagnostic workup and treatment course.
Main Results:
- Patient presented with disorientation, hyponatremia, and neurological deficits.
- Laboratory tests revealed no supratherapeutic immunosuppressant levels, ruling out drug toxicity.
- The clinical picture suggested an opportunistic infection.
Conclusions:
- Immunosuppressed individuals, especially kidney transplant recipients, are at risk for opportunistic infections.
- Neurological symptoms in this population warrant thorough investigation for uncommon pathogens.
- Prompt diagnosis and treatment are crucial for managing such infections.
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