Severe clinical immunodeficiency in a patient with human immunodeficiency virus infection and relatively high CD4 counts: a case report
| Autor: | Mickael Essouma, Mazou Ngou Temgoua, Larry N. Tangie, Antonin Wilson Ndjitoyap Ndam, Ulrich Gabin Kenfack, Celestin Danwang |
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| Přispěvatelé: | UCL - SSS/IREC/EPID - Pôle d'épidémiologie et biostatistique |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Pediatrics medicine.medical_specialty lcsh:Medicine Physical examination HIV Infections Case Report 030204 cardiovascular system & hematology Meningitis Cryptococcal CD4 count Flucytosine 03 medical and health sciences 0302 clinical medicine Stomach Neoplasms medicine Humans Immunodeficiency Sarcoma Kaposi Cryptococcus neoformans biology medicine.diagnostic_test business.industry lcsh:R Gastric Kaposi’s sarcoma General Medicine biology.organism_classification medicine.disease HIV infection CD4 Lymphocyte Count 030220 oncology & carcinogenesis Cryptococcosis Female Sarcoma Headaches medicine.symptom business Fluconazole medicine.drug Neuromeningeal cryptococcosis |
| Zdroj: | Journal of Medical Case Reports Journal of medical case reports, Vol. 13, no.1, p. 86 (2019) Journal of Medical Case Reports, Vol 13, Iss 1, Pp 1-4 (2019) |
| ISSN: | 1752-1947 |
| Popis: | Background The coexistence of neuromeningeal cryptococcosis and Kaposi’s sarcoma is not surprising in a patient with human immunodeficiency virus infection and a low CD4 count, although it is rarely described. However, we describe such an association in a patient with human immunodeficiency virus infection and a relatively high CD4 count. Case presentation A 41-year old Cameroonian woman presented to our hospital with subacute occipital headaches associated with photophobia, blurred vision, phonophobia, projectile vomiting, and tonic seizures. In her past history, there was an human immunodeficiency virus infection known for 12 years, for which she had been taking (with good compliance) tenofovir-lamivudine-efavirenz-based antiretroviral therapy for the same period of time. One month before the consultation, gastric Kaposi’s sarcoma had been diagnosed, justifying the treatment with doxorubicin she had received. A clinical examination was unremarkable. A computed tomography scan of her brain was normal, and cerebrospinal fluid analysis revealed Cryptococcus neoformans. Her CD4 count was 353/mm3. Orally administered antifungal treatment with fluconazole (1200 mg/day) and flucytosine (1500 mg × 4/day) was started immediately, but she died on the sixth day of this treatment. Conclusion This clinical case shows that the coexistence of neuromeningeal cryptococcosis and gastric Kaposi’s sarcoma is possible in all patients with human immunodeficiency virus infection, regardless of CD4 count. |
| Databáze: | OpenAIRE |
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