Disseminated Cryptococcosis with Eosinophilia and Elevated IgE in a Non-HIV-infected Patient

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  • NAKAMURA Keiji
    Department of Medicine and Biosystemic Science, Faculty of Medicine, Kyushu University
  • MIYAKE Noriko
    Department of Medicine and Biosystemic Science, Faculty of Medicine, Kyushu University
  • YARIMIZU Akira
    Department of Medicine and Biosystemic Science, Faculty of Medicine, Kyushu University
  • NISHIDA Ruriko
    Department of Medicine and Biosystemic Science, Faculty of Medicine, Kyushu University Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital
  • KADOWAKI Masako
    National Hospital Organization Fukuoka Hospital
  • TANABE Koichi
    Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases Department of Food Science and Human Nutrition, Faculty of Agriculture, Ryukoku University
  • CHONG Yong
    Department of Medicine and Biosystemic Science, Faculty of Medicine, Kyushu University
  • SHIMODA Shinji
    Department of Medicine and Biosystemic Science, Faculty of Medicine, Kyushu University
  • SHIMONO Nobuyuki
    Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital Center for the Study of Global Infection, Kyushu University Hospital

Bibliographic Information

Other Title
  • 好酸球増多と高IgE 血症を伴った非HIV 患者の播種性クリプトコックス症の1 例
  • 症例 好酸球増多と高IgE血症を伴った非HIV患者の播種性クリプトコックス症の1例
  • ショウレイ コウサンキュウ ゾウ タ ト コウIgE ケツショウ オ トモナッタ ヒHIV カンジャ ノ ハシュセイ クリプトコックスショウ ノ 1レイ

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<p>In general, disseminated cryptococcosis usually occurs among immunocompromised patients, especially those with cell-mediated immunodeficiency, such as HIV-infected patients. We present herein a rare case of an apparently immunocompetent 33-year-old woman who developed disseminated cryptococcal diseases,which included meningitis and pneumonia with eosinophilia, and pulmonary tuberculosis during her disease course. Pneumonia with a diffuse micronodular pattern, immediately followed by meningitis, was diagnosed as disseminated cryptococcosis, because of the presence of yeast-like-fungi demonstrated by transbronchial lung biopsy and a positive cerebrospinal fluid (CSF) culture. In addition, the pneumonia exhibited eosinophilia in the peripheral blood and bronchoalveolar lavage fluid. Re-exacerbation of the pneumonia occurred approximately 3 weeks after onset, along with a sputum culture positive for Mycobacterium tuberculosis.Administration of anti-tuberculosis drugs resulted in recovery from the pulmonary tuberculosis. The treatment of cryptococcal meningitis was initiated using a standard induction regimen ; however, an unrecovered status, highlighted by elevated CSF pressure, persisted. Finally, full recovery was induced by the addition of flucytosine treatment (100mg/kg/day) and repeated daily via lumbar puncture. The allergic condition of this patient may have contributed to the onset of disseminated cryptococcosis. </p>

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 90 (6), 819-824, 2016

    The Japanese Association for Infectious Diseases

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