Cargando…

Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru

Cases of cryptococcosis have been reported in patients with COVID-19. The majority are in patients with severe symptoms or who received immunosuppressants. However, there is still no clear association between COVID-19 and cryptococcosis. We report eight cases of cerebral cryptococcosis associated wi...

Descripción completa

Detalles Bibliográficos
Autores principales: Huamani-Córdova, Juana M., Hueda-Zavaleta, Miguel, Vargas-Bellina, Victor, Simbron-Ribbeck, Lourdes, Chong-Chinchay, Katty del Rosario, Gómez de la Torre, Juan Carlos, Benítes-Zapata, Vicente A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10056744/
https://www.ncbi.nlm.nih.gov/pubmed/36977183
http://dx.doi.org/10.3390/tropicalmed8030182
_version_ 1785016198661931008
author Huamani-Córdova, Juana M.
Hueda-Zavaleta, Miguel
Vargas-Bellina, Victor
Simbron-Ribbeck, Lourdes
Chong-Chinchay, Katty del Rosario
Gómez de la Torre, Juan Carlos
Benítes-Zapata, Vicente A.
author_facet Huamani-Córdova, Juana M.
Hueda-Zavaleta, Miguel
Vargas-Bellina, Victor
Simbron-Ribbeck, Lourdes
Chong-Chinchay, Katty del Rosario
Gómez de la Torre, Juan Carlos
Benítes-Zapata, Vicente A.
author_sort Huamani-Córdova, Juana M.
collection PubMed
description Cases of cryptococcosis have been reported in patients with COVID-19. The majority are in patients with severe symptoms or who received immunosuppressants. However, there is still no clear association between COVID-19 and cryptococcosis. We report eight cases of cerebral cryptococcosis associated with CD4+ T lymphocytopenia in non-HIV patients after SARS-CoV-2 infection. The median age was 57 years and 5/8 were male. In addition, 2/8 of patients had diabetes, and 8/8 had a history of mild COVID-19, with a median of 75 days before diagnosis of cerebral cryptococcosis. All patients denied having received prior immunosuppressive therapy. The most frequent symptoms were confusion (8/8), headache (7/8), vomiting (6/8), and nausea (6/8) All patients were diagnosed by isolating Cryptococcus in cerebrospinal fluid. The median CD4+ and CD8+ T lymphocytes were 247 and 173.5, respectively. Other causes of immunosuppression, such as HIV or HTLV infection, were excluded in all patients. Finally, three patients died, and one presented long-term visual and auditory sequelae. The CD4+/CD8+ T lymphocyte count normalized during follow-up in those patients who survived. We hypothesize that CD4+ T lymphocytopenia in the patients in this case series could increase the risk of cryptococcosis after SARS-CoV-2 infection.
format Online
Article
Text
id pubmed-10056744
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-100567442023-03-30 Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru Huamani-Córdova, Juana M. Hueda-Zavaleta, Miguel Vargas-Bellina, Victor Simbron-Ribbeck, Lourdes Chong-Chinchay, Katty del Rosario Gómez de la Torre, Juan Carlos Benítes-Zapata, Vicente A. Trop Med Infect Dis Case Report Cases of cryptococcosis have been reported in patients with COVID-19. The majority are in patients with severe symptoms or who received immunosuppressants. However, there is still no clear association between COVID-19 and cryptococcosis. We report eight cases of cerebral cryptococcosis associated with CD4+ T lymphocytopenia in non-HIV patients after SARS-CoV-2 infection. The median age was 57 years and 5/8 were male. In addition, 2/8 of patients had diabetes, and 8/8 had a history of mild COVID-19, with a median of 75 days before diagnosis of cerebral cryptococcosis. All patients denied having received prior immunosuppressive therapy. The most frequent symptoms were confusion (8/8), headache (7/8), vomiting (6/8), and nausea (6/8) All patients were diagnosed by isolating Cryptococcus in cerebrospinal fluid. The median CD4+ and CD8+ T lymphocytes were 247 and 173.5, respectively. Other causes of immunosuppression, such as HIV or HTLV infection, were excluded in all patients. Finally, three patients died, and one presented long-term visual and auditory sequelae. The CD4+/CD8+ T lymphocyte count normalized during follow-up in those patients who survived. We hypothesize that CD4+ T lymphocytopenia in the patients in this case series could increase the risk of cryptococcosis after SARS-CoV-2 infection. MDPI 2023-03-22 /pmc/articles/PMC10056744/ /pubmed/36977183 http://dx.doi.org/10.3390/tropicalmed8030182 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Huamani-Córdova, Juana M.
Hueda-Zavaleta, Miguel
Vargas-Bellina, Victor
Simbron-Ribbeck, Lourdes
Chong-Chinchay, Katty del Rosario
Gómez de la Torre, Juan Carlos
Benítes-Zapata, Vicente A.
Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru
title Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru
title_full Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru
title_fullStr Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru
title_full_unstemmed Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru
title_short Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru
title_sort cerebral cryptococcosis associated with cd4+ t-lymphocytopenia in non-hiv patients after sars-cov-2 infection: case series in a specialized institute in lima, peru
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10056744/
https://www.ncbi.nlm.nih.gov/pubmed/36977183
http://dx.doi.org/10.3390/tropicalmed8030182
work_keys_str_mv AT huamanicordovajuanam cerebralcryptococcosisassociatedwithcd4tlymphocytopeniainnonhivpatientsaftersarscov2infectioncaseseriesinaspecializedinstituteinlimaperu
AT huedazavaletamiguel cerebralcryptococcosisassociatedwithcd4tlymphocytopeniainnonhivpatientsaftersarscov2infectioncaseseriesinaspecializedinstituteinlimaperu
AT vargasbellinavictor cerebralcryptococcosisassociatedwithcd4tlymphocytopeniainnonhivpatientsaftersarscov2infectioncaseseriesinaspecializedinstituteinlimaperu
AT simbronribbecklourdes cerebralcryptococcosisassociatedwithcd4tlymphocytopeniainnonhivpatientsaftersarscov2infectioncaseseriesinaspecializedinstituteinlimaperu
AT chongchinchaykattydelrosario cerebralcryptococcosisassociatedwithcd4tlymphocytopeniainnonhivpatientsaftersarscov2infectioncaseseriesinaspecializedinstituteinlimaperu
AT gomezdelatorrejuancarlos cerebralcryptococcosisassociatedwithcd4tlymphocytopeniainnonhivpatientsaftersarscov2infectioncaseseriesinaspecializedinstituteinlimaperu
AT beniteszapatavicentea cerebralcryptococcosisassociatedwithcd4tlymphocytopeniainnonhivpatientsaftersarscov2infectioncaseseriesinaspecializedinstituteinlimaperu