CRYPTOCOCCAL meningitis in a HIV negative newly diagnosed diabetic patient: a CASE report.

Background: This case report emphasizes the need to recognize cryptococcus as a possible cause of meningitis in non-HIV patients in Sub-Saharan Africa and to highlight the possibility of grave outcomes due to the paradoxical immune response in diabetic patients with cryptococcus meningitis. It also...

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Publicado en:BMC Infectious Diseases Vol. 19; no. 1
Autores principales: Owuor, Odhiambo Henry, Chege, Patrick
Formato: case study tables/charts Journal Article
Publicado: BioMed Central 1/3/2019
Acceso en línea:Ver este registro en EBSCOhost
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        atl: CRYPTOCOCCAL meningitis in a HIV negative newly diagnosed diabetic patient: a CASE report.
      aug:
        au:
          Owuor, Odhiambo Henry
          Chege, Patrick
        affil: School of Medicine, Department of Family Medicine, Moi University, P. O. Box, 3900-30100, Eldoret, Kenya
      sug:
        subj:
          Meningitis, Cryptococcal Diagnosis
          Meningitis, Cryptococcal Drug Therapy
          Fluconazole Therapeutic Use
          Antifungal Agents Therapeutic Use
          Diabetes Mellitus Microbiology
          HIV Seronegativity
          Meningitis, Cryptococcal Etiology
          Cryptococcus
          Adult
          Female
          Adult: 19-44 years
          Female
      ab: Background: This case report emphasizes the need to recognize cryptococcus as a possible cause of meningitis in non-HIV patients in Sub-Saharan Africa and to highlight the possibility of grave outcomes due to the paradoxical immune response in diabetic patients with cryptococcus meningitis. It also highlights the need for widespread availability of amphotericin-B and flucytosine in hospitals in Sub-Saharan Africa.Case Presentation: A 27 year old African lady was admitted with generalized tonic clonic seizures lasting 5 to 10 min. These seizures were preceded by severe frontal headaches radiating to the occiput and neck and associated with chills, photophobia and loss of consciousness. She was tachycardic and had tongue bites on the lateral aspects of her tongue. Kernig's and Brudzinski's signs were positive. India ink was positive on two cerebrospinal fluid (CSF) samples. She had hyperglycemia and glucosuria as well. She was diagnosed with cryptococcal meningitis in diabetes and had a remarkable response to fluconazole monotherapy. She went home on maintenance dose of fluconazole having made full recovery. and is currently on prophylactic doses of fluconazole.Conclusions: With the rising prevalence of diabetes in Sub-Saharan Africa, coupled with the low levels of adequate glucose control, cryptococcal meningitis should be considered in the differential diagnosis for diabetic patients presenting with chronic headache, fever and neurologic deficits.
      pubtype: Academic Journal
      doctype:
        case study
        tables/charts
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      ougenre: Article
    language: English
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