<- Home <- Arhive <- Vol. 25, Issue 2, June 2017

Rom J Leg Med25(2)140-145(2017)
© Romanian Society of Legal Medicine

Cryptococcus neoformans associated death in a non-HIV patient

S. A. Florescu, E. Ceausu, C. P. Popescu, E. Nedu, M. Nica, P. Ionescu, S. Smadu, D. Codreanu, P. I. Calistru,

Abstract: Background: In the past 20 years, fungal infections have become more frequent in human pathology because of the rise in the number of patients with immune deficiencies (HIV infections, neoplasm, immuno-suppressive drugs, etc). The biggest influence in the epidemiology of C. neoformans infection in the past 40 years is closely tied to the emergence and evolution of HIV infections on a global scale.
Methods: In “Dr. Victor Babes” Clinical Hospital for Infectious and Tropical Diseases, Bucharest, in the last 10 years were recorded 27 cases of cryptococcal disease in HIV positive patients, and only 3 cases in HIV negative patients. In this article is present a case of C. neoformans meningitis in a HIV negative patient with severe cellular immunity deficiency of an unknown cause.
Results: Multiple laboratory tests were performed on a patient with meningoencephalitis diagnosis at the time of hospital admission. The most important was cerebrospinal fluid analysis, particularly microscopic examination after sediment staining with India ink, leading to visualization of transparent and colourless spots on a black background, suggestive for Cryptococcus spp. Antigen test for the detection of Cryptococcus neoformans in the cerebrospinal fluid was positive. HIV serology was negative and the bacterial etiology was also excluded. Cellular mediated immunity evaluation showed a severe immunosuppression but the cellular immunity deficit cause remained unidentified. Despite the etiological treatment performed according to the antifungigram for 36 days, the patient's condition progressively altered, dying at day 50 of hospitalization.
Keywords: cryptococcal meningitis, mortality, HIV negative.

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