FATAL DISSEMINATED CRYPTOCOCCOSIS WITH RENAL INVOLVEMENT IN AN HIV-INFECTED PATIENT
SUMMARY Introduction: We present a fatal case of disseminated cryptococcosis in a young man whose diagnosis of HIV infection was made at the time of admission to the emergency room. Case report: The patient was a twenty-three-year-old man, with a history of daily fever during one month associated wi...
Published in: | Revista do Instituto de Medicina Tropical de São Paulo |
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Universidade de São Paulo (USP)
2015
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Online Access: | https://doi.org/10.1590/S0036-46652015000400018 https://doaj.org/article/afa477514ea34e5b955516a2b63efdcc |
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ftdoajarticles:oai:doaj.org/article:afa477514ea34e5b955516a2b63efdcc 2024-09-09T19:27:07+00:00 FATAL DISSEMINATED CRYPTOCOCCOSIS WITH RENAL INVOLVEMENT IN AN HIV-INFECTED PATIENT Elizabeth De Francesco DAHER Jarinne Camilo Landim NASSERALA Geraldo Bezerra da SILVA JUNIOR Adriana Regina Vilarinho de OLIVEIRA José Urbano de MEDEIROS NETO Anastácio Queiroz SOUSA 2015-08-01T00:00:00Z https://doi.org/10.1590/S0036-46652015000400018 https://doaj.org/article/afa477514ea34e5b955516a2b63efdcc EN eng Universidade de São Paulo (USP) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652015000400365&lng=en&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/S0036-46652015000400018 https://doaj.org/article/afa477514ea34e5b955516a2b63efdcc Revista do Instituto de Medicina Tropical de São Paulo, Vol 57, Iss 4, Pp 365-367 (2015) Cryptococcus sp HIV AIDS Renal diseases Acute kidney injury Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2015 ftdoajarticles https://doi.org/10.1590/S0036-46652015000400018 2024-08-05T17:49:31Z SUMMARY Introduction: We present a fatal case of disseminated cryptococcosis in a young man whose diagnosis of HIV infection was made at the time of admission to the emergency room. Case report: The patient was a twenty-three-year-old man, with a history of daily fever during one month associated with diarrhea, weight loss, headache, vomiting and generalized seizures. He also had a history of diabetes mellitus, alcoholism and drug addiction. Upon physical examination the patient was pale, disoriented and had periods of agitation. White blood cells count was 3,440/mm3 (5% lymphocytes), hemoglobin was 10g/dL, platelets were 83,000/ mm3. Creatinine was 0.7 mg/dL; urea 19 mg/dL; Na, K, and liver enzymes were within normal limits. Lactic dehydrogenase was 494 IU/L. Cerebrospinal fluid (CSF) analysis revealed 10 white blood cells/mm3 (58% neutrophils, 31% lymphocytes, 11% monocytes) and 2 red blood cells/mm3. India ink test revealed six Cryptococcus yeasts/mm3. CSF glucose was 122 mg/dL and protein was 36 mg/ dL. VDRL test was negative and anti-HIV test was positive. Intravenous hydration, insulin, phenytoin, fluconazole, pyrimethamine, sulfadiazine, folinic acid, and amphotericin B were started. The patient did not improve and became obtunded and hypotensive. He was intubated and put on mechanical respiration. He received vasoactive drugs and died less than 24 hours after admission. A postmortem examination was performed and revealed disseminated cryptococcosis, with severe involvement of the kidneys. Conclusion: Cryptococcosis, as a rule, is a systemic disease that affects mostly immunocompromised individuals, especially patients with AIDS. When diagnosed late in its course it has a very high mortality. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista do Instituto de Medicina Tropical de São Paulo 57 4 365 367 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Cryptococcus sp HIV AIDS Renal diseases Acute kidney injury Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Cryptococcus sp HIV AIDS Renal diseases Acute kidney injury Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Elizabeth De Francesco DAHER Jarinne Camilo Landim NASSERALA Geraldo Bezerra da SILVA JUNIOR Adriana Regina Vilarinho de OLIVEIRA José Urbano de MEDEIROS NETO Anastácio Queiroz SOUSA FATAL DISSEMINATED CRYPTOCOCCOSIS WITH RENAL INVOLVEMENT IN AN HIV-INFECTED PATIENT |
topic_facet |
Cryptococcus sp HIV AIDS Renal diseases Acute kidney injury Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
SUMMARY Introduction: We present a fatal case of disseminated cryptococcosis in a young man whose diagnosis of HIV infection was made at the time of admission to the emergency room. Case report: The patient was a twenty-three-year-old man, with a history of daily fever during one month associated with diarrhea, weight loss, headache, vomiting and generalized seizures. He also had a history of diabetes mellitus, alcoholism and drug addiction. Upon physical examination the patient was pale, disoriented and had periods of agitation. White blood cells count was 3,440/mm3 (5% lymphocytes), hemoglobin was 10g/dL, platelets were 83,000/ mm3. Creatinine was 0.7 mg/dL; urea 19 mg/dL; Na, K, and liver enzymes were within normal limits. Lactic dehydrogenase was 494 IU/L. Cerebrospinal fluid (CSF) analysis revealed 10 white blood cells/mm3 (58% neutrophils, 31% lymphocytes, 11% monocytes) and 2 red blood cells/mm3. India ink test revealed six Cryptococcus yeasts/mm3. CSF glucose was 122 mg/dL and protein was 36 mg/ dL. VDRL test was negative and anti-HIV test was positive. Intravenous hydration, insulin, phenytoin, fluconazole, pyrimethamine, sulfadiazine, folinic acid, and amphotericin B were started. The patient did not improve and became obtunded and hypotensive. He was intubated and put on mechanical respiration. He received vasoactive drugs and died less than 24 hours after admission. A postmortem examination was performed and revealed disseminated cryptococcosis, with severe involvement of the kidneys. Conclusion: Cryptococcosis, as a rule, is a systemic disease that affects mostly immunocompromised individuals, especially patients with AIDS. When diagnosed late in its course it has a very high mortality. |
format |
Article in Journal/Newspaper |
author |
Elizabeth De Francesco DAHER Jarinne Camilo Landim NASSERALA Geraldo Bezerra da SILVA JUNIOR Adriana Regina Vilarinho de OLIVEIRA José Urbano de MEDEIROS NETO Anastácio Queiroz SOUSA |
author_facet |
Elizabeth De Francesco DAHER Jarinne Camilo Landim NASSERALA Geraldo Bezerra da SILVA JUNIOR Adriana Regina Vilarinho de OLIVEIRA José Urbano de MEDEIROS NETO Anastácio Queiroz SOUSA |
author_sort |
Elizabeth De Francesco DAHER |
title |
FATAL DISSEMINATED CRYPTOCOCCOSIS WITH RENAL INVOLVEMENT IN AN HIV-INFECTED PATIENT |
title_short |
FATAL DISSEMINATED CRYPTOCOCCOSIS WITH RENAL INVOLVEMENT IN AN HIV-INFECTED PATIENT |
title_full |
FATAL DISSEMINATED CRYPTOCOCCOSIS WITH RENAL INVOLVEMENT IN AN HIV-INFECTED PATIENT |
title_fullStr |
FATAL DISSEMINATED CRYPTOCOCCOSIS WITH RENAL INVOLVEMENT IN AN HIV-INFECTED PATIENT |
title_full_unstemmed |
FATAL DISSEMINATED CRYPTOCOCCOSIS WITH RENAL INVOLVEMENT IN AN HIV-INFECTED PATIENT |
title_sort |
fatal disseminated cryptococcosis with renal involvement in an hiv-infected patient |
publisher |
Universidade de São Paulo (USP) |
publishDate |
2015 |
url |
https://doi.org/10.1590/S0036-46652015000400018 https://doaj.org/article/afa477514ea34e5b955516a2b63efdcc |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista do Instituto de Medicina Tropical de São Paulo, Vol 57, Iss 4, Pp 365-367 (2015) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652015000400365&lng=en&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/S0036-46652015000400018 https://doaj.org/article/afa477514ea34e5b955516a2b63efdcc |
op_doi |
https://doi.org/10.1590/S0036-46652015000400018 |
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Revista do Instituto de Medicina Tropical de São Paulo |
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57 |
container_issue |
4 |
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365 |
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367 |
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