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Automated Measurement of Cryptococcal Species Polysaccharide Capsule and Cell Body
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[Neurocryptococcosis waiting to be diagnosed].

Ahmed Ashrin1, Suzanne Tran2, Ariane Gavaud3

  • 1Service de Parasitologie-Mycologie, Hôpital Universitaire Pitié-Salpêtrière, Paris, France.

Annales De Biologie Clinique
|August 30, 2024
PubMed
Summary

This case highlights neurocryptococcosis, a severe fungal brain infection, presenting atypically in an immunocompetent individual. Early diagnosis and treatment are crucial for managing this opportunistic infection.

Keywords:
flow cytometrygranulomatosisneurocryptococcosis

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Area of Science:

  • Infectious Diseases
  • Neurology
  • Immunology

Background:

  • Neurocryptococcosis is a serious complication of Cryptococcus neoformans infection.
  • It typically affects individuals with compromised immune systems.

Observation:

  • A 53-year-old man with no prior medical history presented with severe headaches and vomiting.
  • Initial treatment for suspected toxoplasmosis showed temporary improvement, but symptoms recurred.

Findings:

  • Diagnosis confirmed neurocryptococcosis via biological tests, including flow cytometry.
  • The patient exhibited CD4+ T-cell lymphopenia, linked to sarcoidosis-like granulomatosis.
  • Treatment involved Amphotericin B and 5-Fluorocytosine.

Implications:

  • This case demonstrates an unusual presentation of an opportunistic infection in a seemingly immunocompetent host.
  • It underscores the importance of considering neurocryptococcosis even in patients without known immunosuppression.
  • Highlights the diagnostic challenge and need for comprehensive workup in atypical presentations.