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Cryptococcus gattii meningitis in an immunocompromised patient in a hospital in the Peruvian Amazon: case report

Angel A Moreno-Soto1, Rodrigo J Cardenas-Golac1, Marco F Paredes-Obando1

  • 1Universidad Nacional de la Amazonía Peruana, Iquitos, Perú.

Revista Peruana De Medicina Experimental Y Salud Publica
|September 3, 2025
PubMed

Insights

Cryptococcus gattii meningitis occurred in an HIV patient in the Peruvian Amazon. An alternative treatment was used due to resource limitations, highlighting the need for adapted strategies in such settings.

Area of Science:

  • Infectious Diseases
  • Mycology
  • Tropical Medicine

Background:

  • Cryptococcal meningitis is a significant opportunistic infection in individuals with advanced HIV.
  • Cryptococcus gattii is an emerging pathogen causing meningitis, particularly in immunocompromised hosts.
  • Resource-limited settings present challenges in diagnosing and treating fungal infections like cryptococcosis.

Observation:

  • A 36-year-old male with HIV presented with severe neurological symptoms.
  • Cerebrospinal fluid culture confirmed Cryptococcus gattii meningitis.
  • Standard antifungal therapy was unavailable; an alternative regimen of amphotericin B deoxycholate and fluconazole was administered.

Findings:

  • The patient received an alternative antifungal regimen due to resource constraints.
  • Treatment faced challenges, including persistent microorganism detection.
  • Despite challenges, the patient survived, indicating potential effectiveness of adapted therapeutic strategies.

Implications:

  • This case underscores the importance of considering Cryptococcus gattii in the differential diagnosis of cryptococcal meningitis in immunocompromised patients, irrespective of geographical prevalence.
  • The successful management highlights the need for adaptable diagnostic and therapeutic approaches in resource-limited settings.
  • Further research is warranted to optimize antifungal strategies for Cryptococcus gattii infections in underserved regions.

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