A case of cryptococcuria involving the delayed development of cryptococcal meningitis after the initiation of hemodialysis
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- Watanabe Kentaro
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine
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- Nakai Kentaro
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine
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- Fujii Hideki
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine
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- Shimizu Mao
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine
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- Nakano Junko
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine
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- Ishida Risa
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine
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- Watanabe Shuhei
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine
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- Awata Ria
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine
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- Yoshikawa Mikiko
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine
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- Kono Keiji
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine
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- Goto Shunsuke
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine
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- Takiguchi Junji
- Department of Internal Medicine, Kobe Rosai Hospital of the Labor Welfare Corporation
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- Iwasaki Toru
- Iwasaki Internal Medicine Clinic
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- Nishi Shinichi
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine
Bibliographic Information
- Other Title
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- クリプトコッカス尿症を呈し血液透析導入後にクリプトコッカス髄膜炎を発症した1例
- 症例報告 クリプトコッカス尿症を呈し血液透析導入後にクリプトコッカス髄膜炎を発症した1例
- ショウレイ ホウコク クリプトコッカス ニョウショウ オ テイシ ケツエキ トウセキ ドウニュウ ゴ ニ クリプトコッカス ズイマクエン オ ハッショウ シタ 1レイ
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Abstract
<p>Here, we report a case of occult cryptococcuria involving the delayed development of cryptococcal meningitis after the initiation of hemodialysis. The patient was a 72-year-old Japanese male. His medical history included diabetes and hypertension. At the age of 71, he developed tubulointerstitial nephritis, and steroid treatment was started. However, he needed to start hemodialysis therapy due to progressive kidney dysfunction 7 months later. On admission for the initiation of hemodialysis, his laboratory data showed elevated inflammatory marker levels, and Cryptococcus neoformans was isolated from his urine. However, we decided to follow him without providing any specific therapy because a re-examination of his inflammatory marker levels and a urinary culture produced negative findings. He was hospitalized for fever and personality changes 34 days after the initiation of hemodialysis therapy. Cryptococcus was isolated from his spinal fluid, and he was diagnosed with cryptococcal meningitis. He was treated with liposomal amphotericin B and flucytosine, which cured his meningitis. The combination therapy was switched to fluconazole, and he was discharged. Hemodialysis patients are immunocompromised, and hence, are at high risk of infectious diseases, including cryptococcosis. Cryptococcuria can co-exist with systemic cryptococcosis, and therefore, should be followed closely.</p>
Journal
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- Nihon Toseki Igakkai Zasshi
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Nihon Toseki Igakkai Zasshi 50 (2), 157-161, 2017
The Japanese Society for Dialysis Therapy
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Details 詳細情報について
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- CRID
- 1390001204678417280
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- NII Article ID
- 130005438488
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- NII Book ID
- AN10432053
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- ISSN
- 1883082X
- 13403451
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- HANDLE
- 20.500.14094/90006849
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- NDL BIB ID
- 028034829
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- Text Lang
- ja
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- Data Source
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- JaLC
- IRDB
- NDL
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed