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Persistent Cryptococcal Brain Infection despite Prolonged Immunorecovery in an HIV-Positive Patient
Joint Authors
Baxter, Jo
Varma, Anoop
Herwadkar, Amit
Wingfield, Tom
Javier Vilar, F.
du Plessis, Daniel
Blanchard, Tom J.
Source
Case Reports in Neurological Medicine
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-03-04
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Background.
HIV-positive people starting combined antiretroviral therapy may develop immune reconstitution to latent or treated opportunistic infections.
Immune reconstitution to cerebral Cryptococcus is poorly understood and can be fatal.
Case Presentation.
A 33-year-old Zimbabwean female presented with cryptococcal meningitis and newly diagnosed HIV with a CD4 count of 51 cells/μL (4%).
She was treated with amphotericin and flucytosine.
Combined antiretroviral therapy was started four weeks later and she showed early improvement.
However, over the ensuing 18 months, her clinical course was marked by periodic worsening with symptoms resembling cryptococcal meningitis despite having achieved CD4 counts ≥400 cells/μL.
Although initially treated for relapsing cryptococcal immune reconstitution syndrome, a brain biopsy taken 17 months after initial presentation showed budding Cryptococci.
Conclusion.
This unusually protracted case highlights the difficulties in differentiating relapsing cryptococcal meningitis from immune reconstitution and raises questions concerning the optimum timing of initiation of combined antiretroviral therapy in such patients.
American Psychological Association (APA)
Wingfield, Tom& Baxter, Jo& Herwadkar, Amit& du Plessis, Daniel& Blanchard, Tom J.& Javier Vilar, F.…[et al.]. 2014. Persistent Cryptococcal Brain Infection despite Prolonged Immunorecovery in an HIV-Positive Patient. Case Reports in Neurological Medicine،Vol. 2014, no. 2014, pp.1-7.
https://search.emarefa.net/detail/BIM-451048
Modern Language Association (MLA)
Wingfield, Tom…[et al.]. Persistent Cryptococcal Brain Infection despite Prolonged Immunorecovery in an HIV-Positive Patient. Case Reports in Neurological Medicine No. 2014 (2014), pp.1-7.
https://search.emarefa.net/detail/BIM-451048
American Medical Association (AMA)
Wingfield, Tom& Baxter, Jo& Herwadkar, Amit& du Plessis, Daniel& Blanchard, Tom J.& Javier Vilar, F.…[et al.]. Persistent Cryptococcal Brain Infection despite Prolonged Immunorecovery in an HIV-Positive Patient. Case Reports in Neurological Medicine. 2014. Vol. 2014, no. 2014, pp.1-7.
https://search.emarefa.net/detail/BIM-451048
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-451048