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Disseminated infection with Cryptococcus neoformans var neoformans in an 8 years immunocompetent girl.
Indian J Pediatr. 2005 Jan; 72(1):85.IJ

Abstract

Disseminated cryptococcosis is a rare and often fatal disease in children. The majority of cases usually occur in individuals with defective cell-mediated immunity, most commonly due to HIV infection. The authors here in report an 8-year-old girl from Nepal who presented with fever, cough, headache, lymphadenopathy, hepatosplenomegaly and cutaneous lesions. Lymph node biopsy revealed multiple granulomas composed of histiocytes and epitheliold cells along with numerous yeast forms of cryptococcus. Cultures of CSF, sputum and urine yielded cryptococcus neoformans. Surprisingly,the immune function in terms of T-cell number, CD4 : CD8 ratio, serum immunoglobulins and HIV serology was normal. After the diagnosis of disseminated cryptococcosis was established, the patient was treated with 5-fluorocytosine (100 mg/kg/day) for initial two weeks and amphotericin B (1 mg/kg/day) for 13 weeks. Patient responded well to the treatment with disappearance of presenting symptoms, cutaneous lesions, and lymphadenopathy, though she still had hepatosplenomegaly, which also decreased. Unfortunately, she developed loss of vision in 10th week of therapy. The patient was discharged on oral fluconazole (6 mg/kg/day) and no recurrence was found during the follow-up period of more than 9 months. This is the first case of disseminated cryptococcosis with no detectable immune deficit, from India.

Authors+Show Affiliations

Chaudhary MW
Department of Pediatric Medicine, Lady Hardinge Medical College, New Delhi, India.
Sardana K
No affiliation info available
Kumar P
No affiliation info available
Dewan V
No affiliation info available
Anand VK
No affiliation info available

MeSH

Antifungal AgentsChildCryptococcosisFemaleFlucytosineHumansImmunocompetence

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

15684460

Citation

Chaudhary, Mohammed Wajid, et al. "Disseminated Infection With Cryptococcus Neoformans Var Neoformans in an 8 Years Immunocompetent Girl." Indian Journal of Pediatrics, vol. 72, no. 1, 2005, p. 85.
Chaudhary MW, Sardana K, Kumar P, et al. Disseminated infection with Cryptococcus neoformans var neoformans in an 8 years immunocompetent girl. Indian J Pediatr. 2005;72(1):85.
Chaudhary, M. W., Sardana, K., Kumar, P., Dewan, V., & Anand, V. K. (2005). Disseminated infection with Cryptococcus neoformans var neoformans in an 8 years immunocompetent girl. Indian Journal of Pediatrics, 72(1), 85.
Chaudhary MW, et al. Disseminated Infection With Cryptococcus Neoformans Var Neoformans in an 8 Years Immunocompetent Girl. Indian J Pediatr. 2005;72(1):85. PubMed PMID: 15684460.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disseminated infection with Cryptococcus neoformans var neoformans in an 8 years immunocompetent girl. AU - Chaudhary,Mohammed Wajid, AU - Sardana,Kabir, AU - Kumar,Praveen, AU - Dewan,Vivek, AU - Anand,V K, PY - 2005/2/3/pubmed PY - 2006/5/24/medline PY - 2005/2/3/entrez SP - 85 EP - 85 JF - Indian journal of pediatrics JO - Indian J Pediatr VL - 72 IS - 1 N2 - Disseminated cryptococcosis is a rare and often fatal disease in children. The majority of cases usually occur in individuals with defective cell-mediated immunity, most commonly due to HIV infection. The authors here in report an 8-year-old girl from Nepal who presented with fever, cough, headache, lymphadenopathy, hepatosplenomegaly and cutaneous lesions. Lymph node biopsy revealed multiple granulomas composed of histiocytes and epitheliold cells along with numerous yeast forms of cryptococcus. Cultures of CSF, sputum and urine yielded cryptococcus neoformans. Surprisingly,the immune function in terms of T-cell number, CD4 : CD8 ratio, serum immunoglobulins and HIV serology was normal. After the diagnosis of disseminated cryptococcosis was established, the patient was treated with 5-fluorocytosine (100 mg/kg/day) for initial two weeks and amphotericin B (1 mg/kg/day) for 13 weeks. Patient responded well to the treatment with disappearance of presenting symptoms, cutaneous lesions, and lymphadenopathy, though she still had hepatosplenomegaly, which also decreased. Unfortunately, she developed loss of vision in 10th week of therapy. The patient was discharged on oral fluconazole (6 mg/kg/day) and no recurrence was found during the follow-up period of more than 9 months. This is the first case of disseminated cryptococcosis with no detectable immune deficit, from India. SN - 0973-7693 UR - https://www.unboundmedicine.com/medline/citation/15684460/Disseminated_infection_with_Cryptococcus_neoformans_var_neoformans_in_an_8_years_immunocompetent_girl_ DB - PRIME DP - Unbound Medicine ER -