Difficulty diagnosing chronic cryptococcal meningitis in idiopathic CD4+ lymphocytopenia.
A 64-year-old man with idiopathic CD4(+) lymphocytopenia developed cognitive impairment and gait ataxia with isolated obstructive hydrocephalus, which was fatal. Cerebrospinal fluid showed mild pleocytosis, but the etiology was not revealed by extensive analysis. At autopsy, inflammatory cells, CD8(...
| Publicado en: | Neurological Sciences Vol. 32; no. 3; pp. 519 - 525 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | case study Journal Article |
| Publicado: |
Springer Nature
Jun2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104571675&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104571675 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15901874 HVD jtl: Neurological Sciences issn: 15901874 maglogo: N pubinfo: dt: Jun2011 vid: 32 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104571675 104571675 NLM21384279 2011055265 10.1007/s10072-011-0496-5 NLM21384279 104571675 ppf: 519 ppct: 6 formats: tig: atl: Difficulty diagnosing chronic cryptococcal meningitis in idiopathic CD4+ lymphocytopenia. aug: au: Sancesario G Palmieri G Viola G Fontana C Perfetti A Anemona L Floris R Marziali S Bernardi G Spagnoli LG Sancesario, Giuseppe Palmieri, Giampiero Viola, Gemma Fontana, Carla Perfetti, Alessandra Anemona, Lucia Floris, Roberto Marziali, Simone Bernardi, Giorgio Spagnoli, Luigi Giusto affil: Dipartimento di Neuroscienze, Università di Roma Tor Vergata, Via Montpellier 1, 00133 Rome, Italy sug: subj: Cryptococcus Hydrocephalus Complications Hydrocephalus Microbiology Meningitis, Cryptococcal Complications Lymphopenia Complications Chronic Disease Diagnosis, Differential Fatal Outcome Hydrocephalus Diagnosis Male Meningitis, Cryptococcal Diagnosis Meningitis, Cryptococcal Microbiology Middle Age Lymphopenia Diagnosis Lymphopenia Microbiology Middle Aged: 45-64 years Male ab: A 64-year-old man with idiopathic CD4(+) lymphocytopenia developed cognitive impairment and gait ataxia with isolated obstructive hydrocephalus, which was fatal. Cerebrospinal fluid showed mild pleocytosis, but the etiology was not revealed by extensive analysis. At autopsy, inflammatory cells, CD8(+) lymphocytes and abundant macrophages but not CD4(+) lymphocytes were infiltrating the meninges at the base of the brain. Electron microscopy demonstrated that inflammation was caused by Cryptococcus neoformans, which was localized exclusively within macrophages, where it grew with budding. Our study suggests that, in idiopathic CD4(+) lymphocytopenia, macrophages can efficiently phagocytize but inefficiently digest C. neoformans, thus representing a vehicle of chronic intracellular infection. pubtype: Academic Journal doctype: case study Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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