Case report 89

Meredith, Hubert C.; John, Joseph F.; Rogers, Charles I.; Gooneratne, Nihal S.; Kreutner, Albert

doi:10.1007/bf00350599

Cited by 7 publications

(4 citation statements)

References 7 publications

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“…The presence of both tuberculosis and cryptococcosis in the same patients is interesting and was reported in three patients [5,17,20] (Table 1). C. neoformans inhibits the production of tumor necrosis factor alpha (TNF-α), interleukin (IL)-12 and IL-18, and interferon gamma (IFN-γ) (Th1 responses) and stimulates production of IL-10 (a Th2 response) [46].…”

Section: Discussionmentioning

confidence: 80%

Cryptococcus neoformans Abscess and Osteomyelitis in an Immunocompetent Patient with Tuberculous Lymphadenitis

Al‐Tawfiq

Ghandour

2007

Infection

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Infection with Cryptococcus neoformans usually occurs in immunocompromised hosts and may occur in immunocompetent patients. Of all cryptococcal infections, 10-40% of patients have no apparent immune deficiency. Disseminated disease may occur in up to 62% of HIV-seronegative patients with cryptococcosis; however, cryptococcal osteomyelitis is rare. Here, we report an immunocompetent patient with cryptococcal vertebral osteomyelitis and concomitant tuberculous lymphadenitis. The patient received 12 weeks of fluconazole and a 1-year course of anti-tuberculous agents, with complete recovery.

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Section: Discussionmentioning

confidence: 80%

Cryptococcus neoformans Abscess and Osteomyelitis in an Immunocompetent Patient with Tuberculous Lymphadenitis

Al‐Tawfiq

Ghandour

2007

Infection

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“…Cellular immunity defects might predispose patients to cryptococcal infection, which can lead to T cell abnormalities in hosts without other underlying diseases. This possibility suggests that T cell mediated immunity is the primary pathway for preventing cryptococcal infections (Meredith et al, 1979 ; Agadi et al, 2010 ; Jacobson et al, 2012 ). Thus, once a patient is suspected with cryptococcal infection, the evaluation of lymphocyte subsets, including counts and stimulation studies, should be routinely performed to specifically and sensitively reveal the patient immune status, as suggested by Wood and Miedzinski ( 1996 ).…”

Section: Discussionmentioning

confidence: 99%

“…Fever, which is not a primary patient complaint (Behrman et al, 1990 ), was found in only 20.9% of evaluable patients comparable with a previous study, which reported a rate of 18.0% (Wood and Miedzinski, 1996 ). In addition, classic symptoms such as vomiting (Cash and Goodman, 1983 ; Agadi et al, 2010 ), blurred vision (Cash and Goodman, 1983 ; Prendiville et al, 2000 ; Ching et al, 2004 ), dizziness, seizure, diplopia, trismus (Cash and Goodman, 1983 ), limited motion (Bunning and Barth, 1984 ; Ricciardi et al, 1986 ; Sinnott and Holt, 1989 ), paralysis (Meredith et al, 1979 ; Gupta et al, 2003 ), muscle weakness, urinary retention (Gurevitz et al, 1994 ), and sciatica (Houda et al, 2011 ) can occur among patients with cryptococcal infections of specific sites; the location can assist in making the final diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Skeletal cryptococcosis from 1977 to 2013

Zhou

Chu

et al. 2015

Front. Microbiol.

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Skeletal cryptococcosis, an aspect of disseminated cryptococcal disease or isolated skeletal cryptococcal infection, is a rare but treatable disease. However, limited information is available regarding its clinical features, treatment, and prognosis. This systematic review examined all cases published between April 1977 and May 2013 with regard to the factors associated with this disease, including patient sex, age, and epidemiological history; affected sites; clinical symptoms; underlying diseases; laboratory tests; radiological manifestations; and delays in diagnosis, treatment, follow-up assessments, and outcomes. We found that immune abnormality is a risk factor but does not predict mortality; these observations are due to recent Cryptococcus neoformans var gattii (CNVG) outbreaks (Chaturvedi and Chaturvedi, 2011). Dissemination was irrespective of immune status and required combination therapy, and dissemination carried a worse prognosis. Therefore, a database of skeletal cryptococcosis cases should be created.

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“…Forty-five cases including the present case were found and are listed in Table 1. Cases were excluded if they reported positive culture, stain, or histology of other tissues or organs such as cutaneous lesions (6,9), CSF involvement (10,11), sputum (12,13), joint involvement (14-16) or chest x-ray abnormalities that improved with antifungal therapy (17,18). Patients with soft tissue collections or abscesses adjacent to the involved bone were included in this series.…”

Section: Literature Reviewmentioning

confidence: 99%

Skeletal Cryptococcosis: Case Report and Review of the Literature

Wood

Miedzinski

1995

Canadian Journal of Infectious Diseases and Medical Microbiolog

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A case of isolated cryptococcal skull infection is presented in a patient with unexplained CD4 lymphopenia and chronic hepatitis B. All cases of this disease reported in the English literature from 1956 to the present are reviewed. The literature suggests that skeletal cryptococcosis is manifested in only 5% to 10% of recognized cases of disseminated cryptococcosis and that isolated skeletal disease without evidence of other tissue involvement is even less common. When isolated bony disease does occur it tends to occur in immunocompromised hosts, particularly those with defects of cell mediated immunity. Any bony site can be involved, most commonly the vertebrae, with the presentation often being a soft tissue swelling and pain in the affected area. Systemic constitutional symptoms occur in a minority of patients. Radiographic investigations are nonspecific and the gold standard of diagnosis remains culture isolation from bone tissue. The most commonly employed therapy for isolated bone disease is amphotericin alone or combined with surgical debridement. The new azoles may have a role in future therapy.

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Case report 89

Cited by 7 publications

References 7 publications

Cryptococcus neoformans Abscess and Osteomyelitis in an Immunocompetent Patient with Tuberculous Lymphadenitis

Cryptococcus neoformans Abscess and Osteomyelitis in an Immunocompetent Patient with Tuberculous Lymphadenitis

Skeletal cryptococcosis from 1977 to 2013

Skeletal Cryptococcosis: Case Report and Review of the Literature

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