Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique
| Autor: | Sridhar Chilimuri, Charbel Ishak, Paul Kelly, Muhammad Umar Kamal, Chukwunonso Chime, Srinivasan Krishna, Kishore Kumar |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Cryptococcus neoformans
medicine.medical_specialty Leak biology Cerebrospinal fluid leak business.industry Case Report General Medicine Gold standard (test) biology.organism_classification medicine.disease Head trauma Surgery lcsh:Infectious and parasitic diseases 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis medicine lcsh:RC109-216 030212 general & internal medicine Risk factor Complication business Respiratory tract |
| Zdroj: | Case Reports in Infectious Diseases Case Reports in Infectious Diseases, Vol 2019 (2019) |
| ISSN: | 2090-6633 2090-6625 |
| Popis: | Immune deficiency is usually the underlying predisposing factor for cryptococcal meningitis, though there have been case reports of immunocompetent patients presenting with same. The portal of entry for Cryptococcus neoformans is the respiratory tract, and by hematogenous spread, it causes systemic symptoms. The presence of CSF leak is described to have predisposed our immunocompetent patient to infection by this organism possibly through direct spread. The gold standard for diagnosing CSF leak is by cisternography. In this case, we added a technique where nasal gauze is inserted during the procedure and scanned afterwards for dye, thus increasing the confidence of diagnosis of CSF leak through the nares. Prompt diagnosis and treatment is key to prevent adverse outcomes, and we propose that in patients with cryptococcal meningitis without any identifiable risk factor, evaluation for CSF leak should be considered especially with history of head trauma. |
| Databáze: | OpenAIRE |
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