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Cryptococcus neoformans meningitis in an immunocompetent adult: A case report

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Submitted   Oct 12, 2020
Published   Nov 18, 2020
Issue    Vol 3 No 1 (2020)
DOI   10.25082/AGPM.2020.01.002

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Georges Yumba Numbi
Department of Internal Medicine, Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of Congo
Berthe Kamalo Mwad
Department of Internal Medicine, Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of Congo
Olivier Mukuku corresponding author
Institut Supérieur des Techniques Médicales de Lubumbashi, Lubumbashi, Democratic Republic of Congo
Claude Mulumba Mwamba
Department of Internal Medicine, Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of Congo

Abstract

Neuromeningeal cryptococcosis (NMC) is relatively rare in immunocompetent subjects. We report a Congolese case of NMC diagnosed in an apparently immunocompetent subject. A 35-year-old woman was admitted for acute meningoencephalitis. The cerebrospinal fluid (CSF) examination revealed cytological and biochemical abnormalities and the presence of Cryptococcus neoformans on direct examination with India ink and in culture. The serum dosage of cryptococcal antigens was titrated at 1:32. HIV and syphilis antibodies were negative and the blood CD4 lymphocyte count was 610/mm3. The patient had no other immunosuppressive factors, in particular no hematologic abnormalities, no solid tumor, or malnutrition. She was unsuccessfully treated with fluconazole intraveinously, and died after 10 days of treatment. This observation reminds us that NMC can occur in subjects without apparent immunosuppressive factor with a misleading clinical presentation. It is a rare infection with a severe prognosis even in immunocompetent patients.

Keywords
cryptococcosis, immunocompetent, meningoencephalitis

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How to Cite
Numbi, G., Mwad, B., Mukuku, O., & Mwamba, C. (2020). Cryptococcus neoformans meningitis in an immunocompetent adult: A case report. Advances in General Practice of Medicine, 3(1), 23-25. https://doi.org/10.25082/AGPM.2020.01.002
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