Cryptococcus gattii meningoencephalitis in a pediatric patient with cirrhosis. A case report

Authors

DOI:

https://doi.org/10.22267/rus.192103.166

Keywords:

Cryptococcus neoformans/gattii, Meningoencephalitis, Cirrhosis, Mycosis, Child

Abstract

Introduction: In Colombia, Cryptococcosis is a rare invasive fungal infection. Objective: To report the clinical case of a child with Cryptococcus gattii meningoencephalitis whose risk factor was immune dysfunction associated with cirrhosis, a risk factor described in adults which in the reviewed literature has not been reported in children. Materials and methods: A non-systematic review of the literature and a summary of the most relevant aspects of the clinical history were performed. Results: We present the case of a 16-year-old male patient with a history of cirrhosis who came for consultation with a clinical presentation of 8 days of fever, persistent emesis, frontal headache, photophobia and tinnitus. The physical examination did not present neurological alterations. In the study of cerebrospinal fluid, he presented positive direct molecular tests for Cryptococcus neoformans/gattii and the culture reported growth of Cryptococcus gattii. Conclusion: In this case, the importance of suspecting opportunistic infections in patients who have immunodeficiencies not only secondary to HIV infections, but also to those caused by other factors that alter the immune response such as cirrhosis is highlighted.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Castañeda Elizabeth, Lizarazo Jairo. Protocol for the study and management of patients with cryptococcosis, Infectio. 2012; 16(3):123-125.

Lizarazo Jairo, Escandón Patricia, Agudelo Clara, et al. Cryptococcosis in Colombian children and literature review. Mem Inst Oswaldo Cruz. 2014; 109(6): 797-804.

Granados Dp, Castaneda E. Isolation and characterization of Cryptococcus neoformans varieties recovered from natural sources in Bogotá, Colombia, and study of ecological conditions in the area. Microb Ecol. 2005; 49:282-90.

Harris JR, Galanis E, et al. Cryptococcus gattii infections and virulence. Curr Fungal Infect Rep 2014; 8: 81–99.

Vázquez Oscar, Martínez Ignacio, et al. Criptococosis. Historia natural y estado actual del tratamiento. Acta Pediatr Mex. 2005; 26(1):18-28.

Rosen LB, Freeman AF, Yang LM, et al. Anti-GM-CSF autoantibodies in patients with cryptococcal meningitis. J. Immunol. 190, 2013; 3959 –3966.

Albillos A, Lario M, et Al, Cirrhosis-associated immune dysfunction: Distinctive features and clinical relevance. J Hepatol. 2014; 61(6):1385-1396.

Perfect Jhon, Bicanic Tihana, Cryptococcosis diagnosis and treatment: ¿What do we know now? Fungal Genetics and Biology, 2015; 78, 49–54.

Tello Mercedes, Gutiérrez Ericson, et al, Criptococosis. Rev Méd Risaralda. 19(2), 2013, 147-153.

Liesman RM, Strasburg AP, Heitman AK, Theel ES, Patel R, Binnicker MJ. Evaluation of a commercial multiplex molecular panel for diagnosis of infectious meningitis and encephalitis. J Clin Microbiol 2018;56:e01927-17

Perfect JR, Dismukes WE, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america. Clin Infect Dis. 2010;50 (3):291-322.

Day Jeremy, Tran Chau, et al. Combination Antifungal Therapy for Cryptococcal Meningitis. N Engl J Med. 368(14), 2013;1291-1302.

Phillips P, Chapman K, Sharp M, et al. Dexamethasone in Cryptococcus gattii central nervous system infection. Clin Infect Dis 2009; 49: 591–95.

Lane M, McBride J, et al. Steroid responsive late deterioration in Cryptococcus neoformans variety gattii meningitis. Neurology 2004; 63: 713

Published

2019-08-31

How to Cite

1.
Ramírez JL, Mejía LF, Puchana-Quintero ME, Rojas-Hernández JP. Cryptococcus gattii meningoencephalitis in a pediatric patient with cirrhosis. A case report. Univ. Salud [Internet]. 2019Aug.31 [cited 2024Jul.22];21(3):288-92. Available from: https://revistas.udenar.edu.co/index.php/usalud/article/view/3771

Issue

Section

Case report, or case study