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Cryptococcal meningitis associated with steroid therapy.

T S Wilson, W A Fleming, F L Robinson

    Journal of Clinical Pathology
    |November 1, 1970
    PubMed
    Summary
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    Prolonged steroid therapy can lead to Cryptococcus neoformans meningitis. While one patient recovered with amphotericin B, another succumbed to a more virulent strain, highlighting the need for awareness in diagnosing meningitis.

    Area of Science:

    • Medical Mycology
    • Infectious Diseases
    • Neurology

    Background:

    • Prolonged steroid therapy is associated with an increased risk of opportunistic infections.
    • Cryptococcus neoformans is an opportunistic fungal pathogen that can cause meningitis.
    • The incidence of cryptococcal meningitis in immunocompromised patients, particularly those on steroids, is a growing concern.

    Purpose of the Study:

    • To report two cases of Cryptococcus neoformans meningitis in patients receiving long-term steroid therapy.
    • To investigate the virulence of the Cryptococcus neoformans strains isolated from these patients.
    • To emphasize the importance of considering cryptococcal meningitis in patients with obscure meningitis, especially those on steroids.

    Main Methods:

    • Clinical case reporting of two patients with meningitis.

    Related Experiment Videos

  • Antifungal treatment with amphotericin B.
  • Pathogenicity studies to assess fungal virulence.

    • Main Results:

    • One patient responded well to amphotericin B treatment, including relapse.
    • The second patient died despite treatment initiation, with pathogenicity studies indicating a more virulent fungal strain.
    • The study highlights a potential underdiagnosis of cryptococcal meningitis in Britain.

    Conclusions:

    • Long-term steroid therapy increases susceptibility to Cryptococcus neoformans meningitis.
    • Virulence of the fungal strain may influence patient outcomes.
    • Clinicians should consider cryptococcal meningitis in unexplained meningitis cases, particularly in steroid-treated individuals.