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A Trespasser in Lymph Node: A Case Report.

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  • 1Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.

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Summary
This summary is machine-generated.

Cryptococcal meningitis, an opportunistic fungal infection, can present unusually in lymph nodes of HIV-infected individuals. This case highlights cryptococcal lymphadenitis mimicking tuberculosis in an AIDS patient.

Keywords:
cerebrospinal fluid (csf)cryptococcus neoformansfine needle aspiration cytologylymph nodelymphadenitis

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Area of Science:

  • Infectious Diseases
  • Mycology
  • Immunology

Background:

  • Cryptococcal meningitis is a common opportunistic infection in individuals with human immunodeficiency virus (HIV).
  • Lymph node involvement by Cryptococcus is rare and can be misdiagnosed as tuberculosis.
  • Disseminated cryptococcosis is a severe, life-threatening condition frequently observed in acquired immunodeficiency syndrome (AIDS).

Observation:

  • A case report of an HIV-positive patient presenting with pleural effusion and significant lymphadenopathy (mediastinal and axillary).
  • The patient exhibited a low CD4:CD8 lymphocyte ratio, clinically suggestive of disseminated tuberculosis.
  • Diagnostic investigations included cerebrospinal fluid (CSF) analysis and tracheal aspirate culture.

Findings:

  • Tracheal aspirate culture revealed a fungal organism consistent with Cryptococcus.
  • India ink staining of CSF confirmed the presence of Cryptococcus.
  • Cytopathological examination showed necrotizing inflammation and fungal organisms, establishing a diagnosis of cryptococcal lymphadenitis.

Implications:

  • This case underscores the importance of considering fungal infections, particularly Cryptococcus, in the differential diagnosis of lymphadenopathy in immunocompromised patients.
  • Unusual presentations of cryptococcosis can mimic other infectious diseases like tuberculosis, necessitating comprehensive diagnostic approaches.
  • Early and accurate diagnosis of cryptococcal lymphadenitis is crucial for timely treatment and improved patient outcomes in HIV/AIDS patients.