Disseminated cryptococcosis with recurrent multiple abscesses in an immunocompetent patient: a case report and literature review.
Background: Cryptococcus neoformans is frequently present as an opportunistic pathogen mainly affecting immunocompromised populations. Disseminated C. neoformans infection in immunocompetent population is rare and usually involves lung and central nerve system. Cryptococcus from biologic samples can...
| Published in: | BMC Infectious Diseases Vol. 17; pp. 1 - 7 |
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| Main Authors: | , , , , , , , , , , , |
| Format: | case study research Journal Article |
| Published: |
BioMed Central
5/30/2017
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=123350850&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 123350850 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712334 1CHU jtl: BMC Infectious Diseases issn: 14712334 maglogo: N pubinfo: dt: 5/30/2017 vid: 17 pid: 24147 pub: BioMed Central artinfo: ui: 123350850 123350850 NLM28558705 123350850 10.1186/s12879-017-2459-9 NLM28558705 123350850 ppf: 1 ppct: 6 formats: tig: atl: Disseminated cryptococcosis with recurrent multiple abscesses in an immunocompetent patient: a case report and literature review. aug: au: Qiaoling Ruan Yimin Zhu Shu Chen Liping Zhu Shu Zhang Wenhong Zhang Ruan, Qiaoling Zhu, Yimin Chen, Shu Zhu, Liping Zhang, Shu Zhang, Wenhong affil: Department of infectious disease, Huashan Hospital of Fudan University, Shanghai, China sug: subj: Amphotericin B Therapeutic Use Cryptococcosis Etiology Cryptococcosis Diagnosis Antifungal Agents Therapeutic Use Spine Abscess Microbiology Cryptococcus Spine Microbiology Immunocompromised Host Human Aged Male Agglutination Tests Cryptococcosis Drug Therapy Aged: 65+ years Male ab: Background: Cryptococcus neoformans is frequently present as an opportunistic pathogen mainly affecting immunocompromised populations. Disseminated C. neoformans infection in immunocompetent population is rare and usually involves lung and central nerve system. Cryptococcus from biologic samples can easily grow on routine fungal and bacterial culture media. Besides, cryptococcal latex agglutination test has been established as a reliable diagnostic tool with overall sensitivities of 93-100%.Case Presentation: We report a rare disseminated cryptococcosis case which presented with chronic recurrent multiple abscess in an immunocompetent male involving skin, lung, spine and iliac fossa without evidence of central nerve system involving. The results of serum cryptococcal latex agglutination tests and standard microbial cultures were negative. The patient underwent empirical anti-bacterial and anti-tuberculosis therapy which turned out to be effectless. Finally, bedside inoculation of the pus was carried out and revealed Cryptococcus neoformans, which was confirmed by polymerase chain reaction. After the administration of anti-fungal drugs including liposomal amphotericin B, the patient recovered from fever and paraplegia.Conclusions: This case reveals an uncommon pattern of disseminated C. neoformans infection in immunocompetent population presented with chronic multiple abscess and without central nerve system involving. Negative routine microbial cultures may not necessarily rule out cryptococcosis, especially in early stage. Besides, cryptococcal latex agglutination test does have a chance of false negative, which might be related with "capsule-deficiency". Moreover, this phenomenon could be related with low-grade virulence and relative long illness duration. pubtype: Academic Journal doctype: case study research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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