Disseminated Cryptococcal Infection in Apparently Immunocompetent Child: a Case Report

Abstract

Cryptococcal infection is the third most common fungal infection which commonly affects immune-compromised hosts but is increasingly recognized in immunocompetent hosts also. Here, we report disseminated cryptococcosis in an apparently immunocompetent child presenting with high-grade fever, headache and altered sensorium for one month. He had pallor, lymphadenopathy, skin lesions, decreased vision, sixth and seventh cranial nerve palsy, and hepatosplenomegaly. Cerebrospinal fluid analysis report, contrast-enhanced Computed Tomography of brain, and bone-marrow aspiration were normal. The diagnosis was confirmed on bone marrow biopsy. Early diagnosis and timely management of this disease would be life-saving for many children.

Cryptococcomas: Diagnostic Dilemmas with Increasing Incidence

“…Early diagnosis and treatment can prevent both mortality as well as morbidity related to disseminated cryptococcal infections [1] as it goes with other diseases. Hence, the norm of reporting challenging cases along with literature review and critical evaluation of every aspect of the case as done here is indeed of great advantage to the entire medical community and deserves both appreciation and encouragement.…”

“…Dear Editor, I have read the case report entitled "Disseminated Cryptococcal Infection in Apparently Immunocompetent Child: a Case Report" by Basnet et al in Vol 6, No 1 (2023) in your esteemed journal [1].…”

“…Cryptococcus infection is principally caused by two species namely Cryptococcus neoformans and Cryptococcus gattii [1]. Immune compromised patients are mostly affected with C. neoformans infections whereas apparently immune competent patients can be affected with either of these species [2].…”

“…Immune compromised patients are mostly affected with C. neoformans infections whereas apparently immune competent patients can be affected with either of these species [2]. Hence, Cryptococcosis must be considered as one of the differential diagnoses during central nervous system involvement, irrespective of the immune status of the patient [1]. Bone marrow infiltration is not a common presentation and is mostly observed in patients with severe immune deficiency [2].…”