Pulmonary Cryptococcus infections as a manifestation of idiopathic CD4 lymphocytopenia: case report and literature review.
Background: Idiopathic CD4 lymphocytopenia (ICL) is a rare clinical disease with relative CD4 deficiency in the absence of HIV infection. The pathogenicity of ICL is poorly understood with an unclear incidence rate in the general population. Sequelae of ICL includes AIDS-defining infections, which m...
| Published in: | BMC Infectious Diseases Vol. 19; no. 1 |
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| Main Authors: | , , , , |
| Format: | case study Journal Article |
| Published: |
BioMed Central
10/17/2019
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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=139185818&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 139185818 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712334 1CHU jtl: BMC Infectious Diseases issn: 14712334 maglogo: N pubinfo: dt: 10/17/2019 vid: 19 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 139185818 139185818 NLM31623573 139185818 10.1186/s12879-019-4453-x NLM31623573 139185818 ppct: 1 formats: tig: atl: Pulmonary Cryptococcus infections as a manifestation of idiopathic CD4 lymphocytopenia: case report and literature review. aug: au: Thornton, Christina S. Larios, Oscar Grossman, Jennifer Griener, Thomas P. Vaughan, Steven affil: Division of Respirology, Department of Medicine, University of Calgary, 3330 Hospital Drive NW, T2N 4N1, Calgary, AB, Canada sug: subj: Cryptococcus Cryptococcosis Diagnosis Respiratory Tract Infections Diagnosis Lymphopenia Diagnosis Lymphopenia Etiology Antifungal Agents Therapeutic Use Thorax Lung Pathology Cryptococcosis Drug Therapy Cryptococcosis Microbiology Tomography, X-Ray Computed CD4 Lymphocyte Count Respiratory Tract Infections Complications Lung Microbiology Respiratory Tract Infections Drug Therapy Heterocyclic Compounds Therapeutic Use Female Middle Age Respiratory Tract Infections Microbiology Questionnaires Scales Middle Aged: 45-64 years Female ab: Background: Idiopathic CD4 lymphocytopenia (ICL) is a rare clinical disease with relative CD4 deficiency in the absence of HIV infection. The pathogenicity of ICL is poorly understood with an unclear incidence rate in the general population. Sequelae of ICL includes AIDS-defining infections, which most commonly includes Cryptococcus neoformans. Typically, C. neoformans infections present with CNS involvement but rarely with extra-CNS manifestations. Here, we present a rare case of ICL with exclusively primary pulmonary cryptococcus and a review of the literature.Case Presentation: A 56-year-old female presented to our tertiary care hospital requiring a right hip open reduction intervention. The patient became febrile during admission, prompting a work-up that included a chest X-ray showing a peripheral pulmonary solitary nodule. Transthoracic biopsy revealed encapsulated yeast forms in keeping with C. neoformans. CD4 counts, repeated at least one month apart, were < 200 cells/mm3, with negative HIV testing. Flow cytometry and genetic testing were completed to elucidate the etiology of the immune deficiency, both of which were unremarkable. She was subsequently treated with 12 months of posaconazole with clinical resolution.Conclusions: Our patient highlights a rare clinical disease, which a review of literature revealed only five cases in the literature with exclusive pulmonary Cryptococcus in ICL/ This case demonstrates the strong clinical acumen required to properly diagnose and ultimately manage the patient. pubtype: Academic Journal doctype: case study Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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