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Cryptococcal lymphadenitis: an unusual initial presentation of HIV infection
Pia Dogbey1, Marjorie Golden, Nhu Ngo
1Department of Internal Medicine, Yale New Haven Hospital, Saint Raphael Campus, New Haven, Connecticut, USA.
Insights
Cryptococcal lymphadenitis can be the first sign of Human Immunodeficiency Virus (HIV) infection. Lymph node biopsy confirmed the diagnosis, highlighting the need for timely diagnostic methods in HIV-related lymphadenopathy.
Area of Science:
- Infectious Diseases
- Immunology
- Oncology
Background:
- Lymphadenopathy is a common clinical sign in Human Immunodeficiency Virus (HIV) infection, with diverse causes.
- Accurate and prompt diagnosis of lymphadenopathy is crucial for effective patient management and treatment initiation.
Observation:
- This case report details cryptococcal lymphadenitis presenting as the initial manifestation of HIV infection.
- The diagnosis was ultimately confirmed through lymph node biopsy in the reported patient.
Findings:
- Cryptococcal lymphadenitis can serve as an early indicator of undiagnosed HIV infection.
- Lymph node biopsy is a definitive diagnostic tool for identifying the cause of lymphadenopathy in HIV patients.
Implications:
- Early identification of HIV through opportunistic infections like cryptococcal lymphadenitis is vital.
- Fine needle aspiration cytology offers a rapid, cost-effective alternative for diagnosing lymphadenopathy in HIV, potentially enabling earlier diagnosis and treatment.
Abstract:
Lymphadenopathy can occur at any stage of HIV infection, with multiple aetiologies including reactive, infectious and malignant. An accurate and timely diagnosis has obvious implications for treatment. We report cryptococcal lymphadenitis as the presenting manifestation of HIV infection. The diagnosis in our patient was eventually confirmed with a lymph node biopsy. Fine needle aspiration cytology has been shown to be a rapid and cost-effective method, which has been used in the diagnosis of lymphadenopathy in HIV infection, and could have been used to make an earlier diagnosis in our patient.
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