scholarly journals A Rare Case of Amphotericin B Resistant Cryptococcal Meningitis in a HIV Non-reactive Immunocompetent Patient

2018 ◽  
Author(s):  
Pulin Kumar Gupta ◽  
Subodh Kumar Mahto ◽  
Brinder Mohan Singh Lamba ◽  
Mahinder Pal Singh Chawla ◽  
Ankita Sheoran
Keyword(s):  
Amphotericin B ◽  
Cryptococcal Meningitis ◽  
Rare Case ◽  
Immunocompetent Patient

scholarly journals Rare case of amphotericin-B resistant cryptococcal meningitis in HIV non reactive patient

2016 ◽  
Vol 45 ◽  
pp. 199-200 ◽  
Author(s):  
S. Singhal ◽  
P. Gupta ◽  
B.S. Lamba ◽  
P. Singh ◽  
M.I. Chouhan ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Cryptococcal Meningitis ◽  
Rare Case

scholarly journals Case Report: Cryptococcal meningitis in an apparently immunocompetent patient in Nepal - challenges in diagnosis and treatment

2019 ◽  
Vol 4 ◽  
pp. 55
Author(s):  
Ashish Jha ◽  
Sudeep Adhikari ◽  
Keshav Raj Sigdel ◽  
Buddhi Paudyal ◽  
Buddha Basnyat ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Cryptococcal Meningitis ◽  
Liposomal Amphotericin ◽  
Care Delivery ◽  
Immunocompetent Patient ◽  
Liposomal Amphotericin B ◽  
Middle Income ◽  
Middle Income Countries ◽  
Csf Analysis ◽  
The Government

A 50 year old woman from Nepal had clinical features suggestive of meningitis. Cerebrospinal fluid (CSF) analysis was normal except for the presence of cryptococcal antigen. The inclusion of test for Cryptococcus in the CSF helped in making the diagnosis of cryptococcal meningitis in our patient who was apparently immunocompetent. Treatment with liposomal amphotericin B could not be started on time due to financial constraints. The patient had a stroke and further deteriorated. Liposomal amphotericin B is stocked by the government of Nepal for free supply to patients with visceral leishmaniasis, but the policy does not allow the drug to be dispensed for other infections. The family members of our patient acquired the drug within a few days from a government center using their political connections and following administering the treatment the patient improved. This case demonstrates the utility of considering cryptococcal meningitis as a differential diagnosis, and including tests for Cryptococcus when dealing with immunocompetent patients presenting with meningitis. It also demonstrates the effects of the sociopolitical situation on health care delivery in low- and middle-income countries (LMICs) such as Nepal.

scholarly journals Primary Laryngeal Aspergillosis in an Immunocompetent Host

2018 ◽  
Vol 26 (2) ◽  
pp. 131-133
Author(s):  
Kaustuv Das Biswas ◽  
Ankit Choudhary ◽  
Swapan Kumar Ghosh ◽  
Subhradev Biswas
Keyword(s):  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Poor Prognosis ◽  
Rare Case ◽  
Systemic Infection ◽  
Immunocompetent Patient ◽  
Immunocompetent Host ◽  
First Line ◽  
Vocal Cords ◽  
Immunocompetent Patients

Introduction Aspergillosis of Larynx is very rare and may present with symptoms suspicious of malignancy. Prevention of dissemination warrants early diagnosis. It is found mainly in Immunocompromised patients and is usually necrotizing, invasive with disseminated systemic infection, associated with poor prognosis. In Immunocompetent patients it is extremely rare and may present as colonization associated with excellent prognosis. Case Report A 43 year old male patient presented with hoarseness of voice for about 3 months with whitish irregular lesion that involved the anterior 1/3 of both the vocal cords. A cheesy material was found covering indurated lesion of both the vocal cords, intraoperatively. Stripping of mucosa over vocal cords was done and cheesy material collected and sent for HPE which revealed Aspergillus hyphae overlying Mild dysplastic changes. Following diagnosis the patient was followed up with oral dosages of Itraconazole. Discussion The primary Aspergillosis of larynx is extremely rare. Involvement is always secondary to immunocompromised states like AIDS, malignancy, Diabetes, etc. This was a rare case in Immunocompetent patient. Management constitute removal of the vocal cord lesions during biopsy. Amphotericin B is first-line agent for this infection, however aerosolised and liposomal amphotericin B offer effective dosing with less toxicity. Newer antifungal Itraconazole may produce more reliable results.

scholarly journals Case Report: Cryptococcal meningitis in an immunocompetent patient in Nepal - challenges in diagnosis and treatment

2019 ◽  
Vol 4 ◽  
pp. 55
Author(s):  
Ashish Jha ◽  
Sudeep Adhikari ◽  
Keshav Raj Sigdel ◽  
Buddhi Paudyal ◽  
Buddha Basnyat ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Cryptococcal Meningitis ◽  
Liposomal Amphotericin ◽  
Care Delivery ◽  
Immunocompetent Patient ◽  
Liposomal Amphotericin B ◽  
Middle Income ◽  
Middle Income Countries ◽  
Csf Analysis ◽  
The Government

A 50 year old woman from Nepal had clinical features suggestive of meningitis. Cerebrospinal fluid (CSF) analysis was normal except for the presence of cryptococcal antigen. The inclusion of test for Cryptococcus in the CSF helped in making the diagnosis of cryptococcal meningitis in our patient who was apparently immunocompetent. Treatment with liposomal amphotericin B could not be started on time due financial constraints. The patient had a stroke and further deteriorated. Liposomal amphotericin B is stocked by the government of Nepal for free supply to patients with visceral leishmaniasis, but the policy does not allow the drug to be dispensed for other infections. The family members of our patient acquired the drug within a few days from a government center using their political connections and following administering the treatment the patient improved. This case demonstrates the utility of considering cryptococcal meningitis as a differential diagnosis, and including tests for Cryptococcus when dealing with immunocompetent patients presenting with meningitis. It also demonstrates the effects of the sociopolitical situation on health care delivery in low- and middle-income countries (LMICs) such as Nepal.

A Rare Case of Tuberculous Prostatitis

2016 ◽  
Vol 1 (2) ◽  
pp. 33
Author(s):  
Nurul Yaqeen Mohd Esa ◽  
Mohammad Hanafiah ◽  
Marymol Koshy ◽  
Hilmi Abdullah ◽  
Ahmad Izuanuddin Ismail ◽  
...  
Keyword(s):  
Rare Case ◽  
Correct Diagnosis ◽  
Immunocompetent Patient ◽  
Clinical Suspicion ◽  
Tuberculosis Infection ◽  
Advanced Age ◽  
Immunocompromised Patients ◽  
Prostatic Biopsy ◽  
High Clinical Suspicion

Tuberculous prostatitis is an uncommon form of tuberculosis infection. It is commonly seen in immunocompromised patients and in those of middle or advanced age. The diagnosis is often not straight forward due to the nature of its presentation. We report a case of tuberculous prostatitis in a young, healthy and immunocompetent patient, who initially presented with respiratory features, followed by episodes of seizures and testicular swelling. He was finally diagnosed with tuberculous prostatitis after prostatic biopsy. This case illustrates that in a high TB prevalence environment, when symptoms warrant, there should be a high clinical suspicion coupled with a thorough approach in order to arrive at a correct diagnosis of TB prostatitis.

scholarly journals Disseminated Cryptococcosis revealed by transverse myelitis in Immunocompetent patient: a case report and review of the literature

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fangfang Qu ◽  
Zhenzhen Qu ◽  
Yingqian Lv ◽  
Bo Song ◽  
Bailin Wu
Keyword(s):  
Spinal Cord ◽  
Amphotericin B ◽  
Transverse Myelitis ◽  
Immunocompetent Patient ◽  
Lower Limbs ◽  
Coxsackie Virus ◽  
Gadolinium Contrast ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Cord Injury

Abstract Background Transverse myelitis (TM) is due to inflammatory spinal cord injury with bilateral neurologic involvement, which is sensory, motor, or autonomic in nature. It may be associated with autoimmune disease, vaccination, intoxication and infections. The most common infection cause of TM is Coxsackie virus and Mycoplasma pneumoniae. The cryptococcosis is rare. We present the case of disseminated cryptococcosis revealed by transverse myelitis in an immunocompetent 55-year-old male patient. The literature review is also stated. Case presentation The 55-year-old man suffered from gradual numbness, weakness in both lower limbs and finally paralyzed in the bed. The thoracic spine Computed tomography (CT) was normal, but multiple nodules in the lung were accidentally discovered. Thoracic Magnetic Resonance Imaging (MRI) showed diffused thoracic spinal cord thickening and extensively intramedullary T2 hyper intensity areas. Gadolinium contrast enhanced T1WI showed an intramedullary circle-enhanced nodule at 9th thoracic level. Diagnosis was made by histological examination of the bilateral lung biopsy. The patient was treated successfully with systemic amphotericin B liposome and fluconazole and intrathecal dexamethasone and amphotericin B liposome. Conclusions This is a patient with disseminated cryptococcosis involving the lung, spinal cord and adrenal glands, which is rare in the absence of immunodeficiency.

Rare case of Ureaplasma parvum septic arthritis in an immunocompetent patient

2020 ◽  
Vol 13 (9) ◽  
pp. e236396
Author(s):  
Abuzar Ali Asif ◽  
Moni Roy ◽  
Sharjeel Ahmad
Keyword(s):  
Septic Arthritis ◽  
Rare Case ◽  
Immunocompetent Patient ◽  
Next Generation ◽  
Ureaplasma Parvum ◽  
Urogenital Infections ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Diagnostic Modalities

Mycoplasmatacea family comprises two genera: Mycoplasma and Ureaplasma. Ureaplasma parvum (previously known as U. urealyticum biovar 1) commonly colonises the urogenital tract in humans. Although Ureaplasma species have well-established pathogenicity in urogenital infections, its involvement in septic arthritis has been limited to prosthetic joint infections and immunocompromised individuals. We present a rare case of native right knee infection due to U. parvum identified using next-generation sequencing of microbial cell-free DNA testing and confirmed with PCR assays. This rare case of Ureaplasma septic arthritis was diagnosed using newer next-generation DNA sequencing diagnostic modalities and a literature review of prior cases, antibiotic coverage and antimicrobial resistance is incorporated as part of the discussion.

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