A Case of Sepsis and Meningitis due to Capsule-Deficient Cryptococcus neoformans with SIADH
| Autor: | Keizo Yamaguchi, Kohei Hara, Shigeru Kohno, Hiroshi Mukae, Tomiko Takase, Masanori Iwamoto, Toru Ishino, Akitoshi Kinoshita, Masaki Hirota, Norihiko Mori |
|---|---|
| Rok vydání: | 1989 |
| Předmět: |
medicine.medical_specialty
Miconazole Gastroenterology Inappropriate ADH Syndrome Sepsis Amphotericin B Internal medicine medicine Humans Meningitis Leukocytosis Aged Aged 80 and over Cryptococcus neoformans Demeclocycline biology business.industry Drug Resistance Microbial Cryptococcosis General Medicine biology.organism_classification medicine.disease Syndrome of inappropriate antidiuretic hormone secretion Female medicine.symptom Hyponatremia business medicine.drug |
| Zdroj: | Journal of the Japanese Association for Infectious Diseases. 63:1206-1211 |
| ISSN: | 1884-569X 0387-5911 |
| Popis: | Capsule-deficient Cryptococcus neoformans (CN-CD) infection is very rare. The authors recently experienced the case of CN-CD infection with the complication of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) in a 83 year old woman. She was admitted to our hospital with the complaints of fever and general fatigue on June 10, 1987. At the time of admission, there were no abnormal findings except a mildly lowered consciousness level on physical examination, there were no abnormal neurological finding nor meningeal signs. Laboratory data revealed a mild leukocytosis and hyponatremia. Chest X-P showed a few small nodular shadows scattered in both lungs. Antibiotics therapy was of no help and hyponatremia became worse. Then with the suspicion of SIADH, Demeclocycline was administered and limitation of water intake was decreased and hyponatremia improvement was used. Yeast-like fungi was detected in the venous blood culture and in the cerebrospinal fluid (cell count: 252/3) CN-CD by India-ink preparation and bacteriological nature were determined. We made a diagnosis of sepsis and meningitis by CN-CD accompanied with SIADH. In spite of Miconazole administration intravenously and intrathecally, she died 2 months after admission. The minimal inhibitory concentration (micrograms/ml) of antibiotics against the isolated CN-CD was as follows: Amphotericin B: 0.78, 5-PC: 1.56, Miconazole less than or equal to 0.05, Nystatin: 25, Ketoconazole: 0.78. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|