Non-neoformans Cryptococcus species, including C. laurentii and C. albidus, have historically been classified as exclusively saprophytic. However, recent studies have increasingly implicated these organisms as the causative agent of opportunistic infections in humans. Herein, the case is presented of C. laurentii meningitis in a critically ill patient receiving corticosteroids. C. laurentii has been implicated in an additional 18 cases of opportunistic infection, predominantly of the skin, bloodstream, and central nervous system. The most clinically significant risk factors for non-neoformans cryptococcal infections include: impaired cell-mediated immunity, recent corticosteroid use, and invasive catheter placement. This article provides a comprehensive review of the clinical relevance, pathogenesis, risk factors, and treatment of non-neoformans Cryptococcus species.
The Coronavirus disease (COVID-19) pandemic, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has led to tremendous morbidity and mortality. Various inflammatory markers have been monitored and considered to be associated with disease prognosis. One of the major sources of comorbidity involved has been development of thrombosis alongside the infection. This prothrombotic phenomenon considered, COVID-19-associated coagulopathy (CAC), has been the center of discussion in dealing with this infection. There still remains ambiguity regarding management guidelines for thromboprophylaxis dosing and therapeutic anticoagulation. We present a case of severe SARS-CoV-2 infection complicated by thrombosis despite therapeutic anticoagulation contributing to prolonged intensive care unit and hospital stay.
Acute chest syndrome is a complication of sickle cell disease and represents the highest cause of mortality in those afflicted with the disorder. Pregnancy represents an increased risk for complications of sickle cell disease in both the mother and fetus. We present a case of a 20-year-old patient with known sickle cell disease who was at 25-week gestation and developed acute chest syndrome refractory to conventional therapies and requiring emergency cesarean section. Following delivery, the patient developed acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO). The patient and infant eventually made full recoveries. This case highlights the importance of aggressive management of ACS and careful monitoring in a pregnant patient.
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