1887

Abstract

Introduction:

A 41‐year‐old man with a history of alcoholic cirrhosis presented to Patan Hospital in Kathmandu, Nepal, with a severe headache.

Case presentation:

Clinical examination found an isolated sixth nerve palsy of the left side with normal blood parameters and a normal brain scan. An initial cerebrospinal fluid analysis found lymphocytosis, with a significantly elevated protein level and reduced glucose. Tubercular meningitis was considered; however, the patient did not improve and a re‐examination of the cerebrospinal fluid confirmed cryptococcal meningitis.

Conclusion:

After diagnosis the patient was treated with amphotericin B. Despite all efforts the patient died 5 days later.

  • This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/).
Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.001982
2014-09-01
2024-04-26
Loading full text...

Full text loading...

/deliver/fulltext/jmmcr/1/3/jmmcr001982.html?itemId=/content/journal/jmmcr/10.1099/jmmcr.0.001982&mimeType=html&fmt=ahah

References

  1. Bicanic T., Harrison T.S. ( 2005). Cryptococcal meningitis. Br Med Bull 2005:99–118 [CrossRef]
    [Google Scholar]
  2. CDC( 2013). Cryptococcus neoformans cryptococcosis. Cryptococcosis statistics http://www.cdc.gov/fungal/cryptococcosis-neoformans/statistics.html
    [Google Scholar]
  3. Coagliati M. ( 2013). Global molecular epidemiology of Crypotococcus neoformans and Cryptococcus gattii: an atlas of the molecular types. Scientifica 2013:23
    [Google Scholar]
  4. Graybill J.R., Sobel J., Saag M., Van Der Horst C., Powderly W., Cloud G., Riser L., Hamill R., Dismukes W. ( 2000). Diagnosis and management of increased intracranial pressure in patients with AIDS and cryptococcal meningitis. The NIAID Mycoses Study Group and AIDS Cooperative Treatment Groups. Clin Infect Dis 30:47–54 [CrossRef]
    [Google Scholar]
  5. Hsu C.C., Leevy C.M. ( 1971). Inhibition of PHA‐stimulated lymphocyte transformation by plasma from patients with advanced alcoholic cirrhosis. Clin Exp Immunol 8:749–760
    [Google Scholar]
  6. Mabee C.L., Mabee S.W., Kirkpatrick R.B., Koletar S.L. ( 1995). Cirrhosis: a risk factor for cryptococcal peritonitis. Am J Gastroenterol 90:2042–2045
    [Google Scholar]
  7. Malik R., Mookerjee R.P., Jalan R. ( 2009). Infection and inflammation in liver failure: two sides of the same coin. J Hepatol 51:426–429 [CrossRef]
    [Google Scholar]
  8. Nouri‐Aria K.T., Alexander G., Portman B.C., Hegarty J.E., Eddleston A., Williams R. ( 1986). T and B cell function in alcoholic liver disease. J Hepatol 2:195–207 [CrossRef]
    [Google Scholar]
  9. Perfect J.R., Casadevall A. ( 2002). Cryptococcosis. Infect Dis Clin North Am 2002:837–874 [CrossRef]
    [Google Scholar]
  10. Saag M.S., Powderly W., Cloud G.A., Robinson P., Grisco M.H., Sharkey P.K. ( 1992). Comparision of amphotericin B with fluconazole in the treatment of acute AIDS‐associated cryptococcal meningitis. The NIAID Mycoses Study Group and the AIDS Clinical Trails Group. N Engl J Med 1992:83–89 [CrossRef]
    [Google Scholar]
  11. Tritto G., Bechlis Z., Stadbauer V., Davies N., Frances R., Al E. ( 2011). Evidence of neutrophil functional defect despite inflammation in stable cirrhosis. J Hepatol 51:574–581 [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmmcr/10.1099/jmmcr.0.001982
Loading
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error