Fatal cryptococcal meningitis in a HIV‐seronegative patient with liver cirrhosis

K. C. Radheshyam; Abhilasha Karkey; Krishna Govinda Prajapati; Stephen Baker; Buddha Basnyat

doi:10.1099/jmmcr.0.001982

Fatal cryptococcal meningitis in a HIV‐seronegative patient with liver cirrhosis

K. C. Radheshyam¹, Abhilasha Karkey², Krishna Govinda Prajapati³, Stephen Baker^4,5, Buddha Basnyat^2,3
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Affiliations: ¹ Patan Academy of Health Sciences, Patan Hospital, Kathmandu, Nepal ² Oxford University Clinical Research Unit, Patan Hospital, Kathmandu, Nepal ³ Department of Microbiology and Immunology, Patan Hospital, Kathmandu, Nepal ⁴ Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam ⁵ Centre for Tropical Medicine, Oxford University, Oxford, UK
Correspondence Abhilasha Karkey [email protected]
First Published: 01 September 2014 https://doi.org/10.1099/jmmcr.0.001982

Abstract

Introduction:

A 41‐year‐old man with a history of alcoholic cirrhosis presented to Patan Hospital in Kathmandu, Nepal, with a severe headache.

Case presentation:

Clinical examination found an isolated sixth nerve palsy of the left side with normal blood parameters and a normal brain scan. An initial cerebrospinal fluid analysis found lymphocytosis, with a significantly elevated protein level and reduced glucose. Tubercular meningitis was considered; however, the patient did not improve and a re‐examination of the cerebrospinal fluid confirmed cryptococcal meningitis.

Conclusion:

After diagnosis the patient was treated with amphotericin B. Despite all efforts the patient died 5 days later.

Received: 19/02/2014
Accepted: 23/06/2014
Published Online: 01/09/2014

Keyword(s): amphotericin B , cirrhosis , cryptococcal antigen lateral flow assay , headache and meningitis

This is an Open Access article published by the Microbiology Society under the Creative Commons Attribution License

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JMM Case Reports

Volume 1, Issue 3

Research Article

Open Access

Fatal cryptococcal meningitis in a HIV‐seronegative patient with liver cirrhosis

Abstract

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