First case report of fulminant septic shock from meningococcemia associated with Cryptococcus neoformans coinfection in an immunocompetent patient

Dienstmann, Guilherme; Avi, Karina Tolfo; Leite, Luiz Arthur Calheiros; Alano, Joaquim Squizatto; Souza, Matheus Leite Ramos de; Mulazani, Marcelo da Silva; Mendivil, Paula Cristina Gern

doi:10.1016/j.mmcr.2019.10.003

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…In a local study, cryptococcosis was an HIV/AIDS-defining disease in 40% of cases, so it is important to rule out causes of immunosuppression associated with fungal infection [7]. On the other hand, systemic cryptococcosis in hosts without impairment of immune system is rare and PCC in these immunocompetent patients even more rarely described on the literature [2,[8][9][10][11][12][13][14][15][16]. Our case contributes to the scarce data; we show an immunocompetent patient, without any typical predisposition factor for cryptococcosis, that fulfilled all criteria for PCC diagnoses caused by C. neoformans [1].…”

Section: Discussionmentioning

confidence: 99%

Primary Cutaneous Cryptococcosis Caused by Cryptococcus neoformans in an Immunocompetent Patient

Orzechowski Xavier

2023

JCMR

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Background: Primary Cutaneous Cryptococcosis (PCC) is an uncommon disease restricted to cutaneous tissues caused by Cryptococcus spp. Case-report: We report a PCC case in a patient without any underlying disease. A 44-year-old man from Southern Brazil was referred to the hospital with 3-year recurrent skin lesions. A biopsy showed typical rounded and encapsulated blastoconidia typical of Cryptococcus and C. neoformans was identified in culture. Treatment with fluconazole (600 mg/day) was prescribed with improvement of the lesions. During the follow-up a self-reported interruption of treatment was detected and after 1 year of treatment, complete clinical cure was not yet achieved. Conclusion: This uncommon case reinforces the importance of mycologic examinations for correct diagnoses.

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Section: Discussionmentioning

confidence: 99%

Primary Cutaneous Cryptococcosis Caused by Cryptococcus neoformans in an Immunocompetent Patient

Orzechowski Xavier

2023

JCMR

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“…Необходимо отметить, что септический шок, вызванный Neisseria meningitidis, является наиболее тяжелым из-за быстрой прогрессии клинических симптомов и раннего развития полиорганной недостаточности [12,20]. Для такого септического шока характерен наиболее выраженный дисбаланс между свертывающей и фибринолитической системами крови.…”

Section: патофизиология септического шокаunclassified

Topical issues of clinical symptoms and diagnostics of septic shock

Гоманова

Fokina

2022

Russian Journal of Infection and Immunity

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Currently, septic shock remains an unresolved public health problem that leads to serious epidemiological, economic and social problems. Septic shock is a common hemodynamic disorder caused by the interaction between pathogenic microbes and host cells, resulting in developing hypoxia, severe metabolic disorders and multiple organ failure. By now, no unified concept for pathophysiology of septic shock are available. However, the aforementioned data prove that one of the key arms in the pathogenesis is endothelial dysfunction and associated ischemic disorders. In the clinical course of septic shock, three stages are distinguished: the stage of compensation, decompensation as well as the stage of irreversible disorders. The initial stage, or the stage of compensation, is characterized by the activated inflammatory response against infectious agents. Clinically, this stage is characterized by the development of warm shock: fever, dermal hyperemia, hyperventilation, increased cardiac output, and tachycardia. The second stage in developing septic shock is characterized by arising cold shock as a consequence of escalating heart and respiratory failure. The final stage is the development of multiple organ failure manifested by emerging shock organs. Multiple organ failure occurs due to microthrombosis and increasing ischemia, which leads to hypoxia and development of mitochondrial dysfunction in immune cells. At this stage patients are characterized by the progressive cyanosis, developing anuria and intestinal obstruction, as well as altered mental status. Laboratory and instrumental diagnostics of septic shock is a promising approach to examine septic shock. The level of serum C-reactive protein, lactate, and proinflammatory cytokines are not highly specific diagnostic parameters of septic shock, because they can be found in any inflammatory process. Today, the promising diagnostic markers are pentraxin-3, high-density lipoproteins, and phosphatidylcholine. The severity of septic shock can be assessed by determining blood schistocytes, central venous pressure, and the ratio of venous-arterial CO2 and arterial-venous O2 pressure. The following diagnostic methods can be used to determine multiple organ failure: level of serum proenkephalin A119159 and heparin-binding protein; echocardiography, troponin I concentration and N-terminal pro-b-type natriuretic peptides; measuring activity of the renin-angiotensin-aldosterone system. Here we discuss the key aspects of pathogenesis, clinical picture and morphological changes of septic shock. The promising methods for diagnosing the disease and its complications have been studied.

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“…A fase de indução é realizada com a administração de anfotericina B, por pelo menos duas semanas, associada ou não a fluconazol ou flucitosina, com repetidas punções lombares a fim de comprovar a esterilização do LCR e monitoramento da hidrocefalia. Na fase de consolidação é utilizado o fluconazol em dose de 400 a 800 mg/d por 8 semanas e na terapia de manutenção administra-se o fluconazol 200 mg/d por pelo menos 12 meses (Dienstmann et al, 2019).…”

Section: Introductionunclassified

Neurocriptococose por Cryptococcus neoformans em paciente imunocompetente

Martinussi,

Marçal

et al. 2024

CLCS

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A neurocriptococose consiste em uma infecção que atinge o Sistema Nervoso Central, e é provocada pelo fungo Cryptococcus sp. Normalmente atinge indivíduos imunossuprimidos, mas ainda que raramente, pode atingir indivíduos imunocompetentes. Este estudo objetiva relatar o caso de um paciente jovem imunocompetente, com quadro de cefaleia, cegueira e desenvolvimento de hipertensão intracraniana por doença criptocócica. Trata-se de um estudo descritivo retrospectivo, realizado no Hospital Universitário da Faculdade de Medicina da Universidade Federal do Mato Grosso do Sul (HU - UFGD). A pesquisa foi realizada com um paciente do sexo masculino, o qual foi internado no HU – UFGD com neurocriptococose no período de julho a outubro de 2022. Os dados coletados e utilizados na pesquisa foram autorizados mediante assinatura do Termo de Consentimento Livre e Esclarecido (TCLE) e demais documentações em conformidade com o Comitê de Ética e Pesquisa (CEP) de parecer número 6.166.391. Assim, compreende-se que este estudo auxilia a pensarmos na possibilidade de neurocriptococose em pacientes sem imunodeficiência quando estivermos diante de um quadro compatível com meningite, hipertensão intracraniana e até mesmo crises convulsivas, podendo assim prestarmos assistência rápida e corretamente na tentativa de prevenirmos possíveis sequelas. Por fim, vale ressaltar a necessidade de produções científicas que abordem a temática.

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First case report of fulminant septic shock from meningococcemia associated with Cryptococcus neoformans coinfection in an immunocompetent patient

Cited by 4 publications

References 13 publications

Primary Cutaneous Cryptococcosis Caused by Cryptococcus neoformans in an Immunocompetent Patient

Primary Cutaneous Cryptococcosis Caused by Cryptococcus neoformans in an Immunocompetent Patient

Topical issues of clinical symptoms and diagnostics of septic shock

Neurocriptococose por Cryptococcus neoformans em paciente imunocompetente

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