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Gastroduodenal Cryptococcus in an AIDS Patient Presenting With Melena

Gastrointestinal cryptococcosis is extremely rare with only a few case reports found in the literature and involvement primarily identified post-mortem. This is a case of 54-year-old man with a 20-year history of poorly controlled human immunodeficiency virus presented with constitutional symptoms a...

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Autores principales: Liu, Yang, Patel, Anish A., Shaw, Janet C., Fillman, Eric P., Lamb, Paul B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051116/
https://www.ncbi.nlm.nih.gov/pubmed/27785222
http://dx.doi.org/10.4021/gr507w
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author Liu, Yang
Patel, Anish A.
Shaw, Janet C.
Fillman, Eric P.
Lamb, Paul B.
author_facet Liu, Yang
Patel, Anish A.
Shaw, Janet C.
Fillman, Eric P.
Lamb, Paul B.
author_sort Liu, Yang
collection PubMed
description Gastrointestinal cryptococcosis is extremely rare with only a few case reports found in the literature and involvement primarily identified post-mortem. This is a case of 54-year-old man with a 20-year history of poorly controlled human immunodeficiency virus presented with constitutional symptoms along with melena. Diagnostic work up with esophagogastroduodenoscopy showed 4 irregular ulcers in the stomach notable for red-pigmented lesions within the ulcers, erythematous mucosa in the antrum and patchy friable mucosa in the duodenum. H&E staining and Mucicarmine staining showed findings consistent with C. neoformans. Blood culture and cerebrospinal fluid studies also revealed C. neoformans. Cryptococcus neoformans is an AIDS defining illness that most commonly presents as meningoencephalitis and pneumonitis. Key management principles includes: induction of antifungal therapy followed by consolidation and maintenance; management of elevated intracranial pressure and immune reconstitution inflammatory syndrome. Although the organism can infect nearly all organs, gastrointestinal involvement is rarely described. Our case highlights the fact that gastrointestinal C. neoformans infection can be associated with upper gastrointestinal symptoms and may be the initial presentation of disseminated cryptococcosis.
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spelling pubmed-50511162016-10-26 Gastroduodenal Cryptococcus in an AIDS Patient Presenting With Melena Liu, Yang Patel, Anish A. Shaw, Janet C. Fillman, Eric P. Lamb, Paul B. Gastroenterology Res Case Report Gastrointestinal cryptococcosis is extremely rare with only a few case reports found in the literature and involvement primarily identified post-mortem. This is a case of 54-year-old man with a 20-year history of poorly controlled human immunodeficiency virus presented with constitutional symptoms along with melena. Diagnostic work up with esophagogastroduodenoscopy showed 4 irregular ulcers in the stomach notable for red-pigmented lesions within the ulcers, erythematous mucosa in the antrum and patchy friable mucosa in the duodenum. H&E staining and Mucicarmine staining showed findings consistent with C. neoformans. Blood culture and cerebrospinal fluid studies also revealed C. neoformans. Cryptococcus neoformans is an AIDS defining illness that most commonly presents as meningoencephalitis and pneumonitis. Key management principles includes: induction of antifungal therapy followed by consolidation and maintenance; management of elevated intracranial pressure and immune reconstitution inflammatory syndrome. Although the organism can infect nearly all organs, gastrointestinal involvement is rarely described. Our case highlights the fact that gastrointestinal C. neoformans infection can be associated with upper gastrointestinal symptoms and may be the initial presentation of disseminated cryptococcosis. Elmer Press 2013-02 2013-03-09 /pmc/articles/PMC5051116/ /pubmed/27785222 http://dx.doi.org/10.4021/gr507w Text en Copyright 2013, Liu et al. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Liu, Yang
Patel, Anish A.
Shaw, Janet C.
Fillman, Eric P.
Lamb, Paul B.
Gastroduodenal Cryptococcus in an AIDS Patient Presenting With Melena
title Gastroduodenal Cryptococcus in an AIDS Patient Presenting With Melena
title_full Gastroduodenal Cryptococcus in an AIDS Patient Presenting With Melena
title_fullStr Gastroduodenal Cryptococcus in an AIDS Patient Presenting With Melena
title_full_unstemmed Gastroduodenal Cryptococcus in an AIDS Patient Presenting With Melena
title_short Gastroduodenal Cryptococcus in an AIDS Patient Presenting With Melena
title_sort gastroduodenal cryptococcus in an aids patient presenting with melena
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051116/
https://www.ncbi.nlm.nih.gov/pubmed/27785222
http://dx.doi.org/10.4021/gr507w
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