Disseminated Cryptococcus neoformans presenting with an isolated pleural effusion in a patient receiving temozolomide and long-term steroids.
Cryptococcus neoformans is a ubiquitous environmental organism found worldwide. Infection with this organism occurs predominantly in immunocompromised hosts, including persons living with HIV or those with impaired cellular immunity. Cryptococcal pleural effusions have been described in cases with e...
| Publicado en: | BMJ Case Reports Vol. 16; no. 11; pp. 1 - 6 |
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| Autores principales: | , , , |
| Formato: | Journal Article |
| Publicado: |
BMJ Publishing Group
Nov2023
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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=174041842&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 174041842 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1757790X B755 jtl: BMJ Case Reports issn: 1757790X maglogo: N pubinfo: dt: Nov2023 vid: 16 iid: 11 pid: 8280 pub: BMJ Publishing Group artinfo: ui: 174041842 10.1136/bcr-2023-256255 174041842 ppf: 1 ppct: 5 formats: tig: atl: Disseminated Cryptococcus neoformans presenting with an isolated pleural effusion in a patient receiving temozolomide and long-term steroids. aug: au: Fraser, Brooke Munawar, Maha Halani, Sheliza Sabur, Natasha affil: Medicine, University of Toronto, Toronto, Ontario, Canada. sug: ab: Cryptococcus neoformans is a ubiquitous environmental organism found worldwide. Infection with this organism occurs predominantly in immunocompromised hosts, including persons living with HIV or those with impaired cellular immunity. Cryptococcal pleural effusions have been described in cases with extensive pulmonary involvement. Here we present the case of a woman receiving temozolomide and steroids for glioblastoma multiforme, who developed cough and dyspnoea and was found to have an uncomplicated pleural effusion. Pleural fluid culture grew Cryptococcus neoformans with negative culture on bronchoalveolar lavage. High serum cryptococcal antigen titre of 1:64 prompted lumbar puncture which demonstrated positive cerebrospinal fluid for Cryptococcus neoformans. She was treated with liposomal amphotericin B and flucytosine, followed by consolidation and maintenance therapy with fluconazole. Pleural involvement in the absence of pulmonary involvement has rarely been reported. We review pulmonary and radiographic manifestations of cryptococcal infection, when to assess for disseminated infection, and management principles. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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