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A Rare Presentation of Cryptococcal Meningoencephalitis in an Immunocompetent Individual.

TitleA Rare Presentation of Cryptococcal Meningoencephalitis in an Immunocompetent Individual.
Publication TypeJournal Article
Year of Publication2017
AuthorsMalhotra A, Rao Q, Kelly S, Schwartz D, Chow R
JournalClin Pract
Volume7
Issue4
Pagination1002
Date Published2017 Sep 15
ISSN2039-7275
Abstract

Cryptococcal meningoencephalitis is a leading of morbidity and mortality in immunocompromised individuals worldwide. However, there are few documented cases in immunocompetent patients. We present a rare case of disseminated Cryptococcus with progression to meningoencephalitis in an immunocompetent patient, with a possible atypical presentation. Magnetic resonance imaging of the brain and electroencephalogram to rule out brain metastasis were negative. Lumbar puncture resulted positive for antigen at titers of 1:2048 and a detailed history later revealed occupational exposure to bird dander by cleaning floors and cages. Diagnosis is challenging, with delays often resulting in increased morbidity and mortality. Cerebrospinal fluid and serum antigen play a key role in both diagnosis and determining treatment efficacy. Furthermore, current treatment guidelines are used for immunocompromised individuals. Due to the significant side effects of these medications, further research is needed to determine the optimal treatment duration for immunocompetent patients to minimize the need for unnecessary therapy.

DOI10.4081/cp.2017.1002
Alternate JournalClin Pract
PubMed ID28959388
PubMed Central IDPMC5607658

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