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Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique
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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402215/ https://www.ncbi.nlm.nih.gov/pubmed/30915245 http://dx.doi.org/10.1155/2019/3510860 |
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author | Chime, Chukwunonso Ishak, Charbel Kumar, Kishore Kamal, Muhammad Krishna, Srinivasan Kelly, Paul Chilimuri, Sridhar |
author_facet | Chime, Chukwunonso Ishak, Charbel Kumar, Kishore Kamal, Muhammad Krishna, Srinivasan Kelly, Paul Chilimuri, Sridhar |
author_sort | Chime, Chukwunonso |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6402215 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-64022152019-03-26 Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique Chime, Chukwunonso Ishak, Charbel Kumar, Kishore Kamal, Muhammad Krishna, Srinivasan Kelly, Paul Chilimuri, Sridhar Case Rep Infect Dis Case Report 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. Hindawi 2019-02-20 /pmc/articles/PMC6402215/ /pubmed/30915245 http://dx.doi.org/10.1155/2019/3510860 Text en Copyright © 2019 Chukwunonso Chime et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under 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 Chime, Chukwunonso Ishak, Charbel Kumar, Kishore Kamal, Muhammad Krishna, Srinivasan Kelly, Paul Chilimuri, Sridhar Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique |
title | Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique |
title_full | Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique |
title_fullStr | Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique |
title_full_unstemmed | Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique |
title_short | Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique |
title_sort | cryptococcal meningitis in a hiv seronegative patient: a rare complication of cerebrospinal fluid leak detected with a new cisternographic technique |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402215/ https://www.ncbi.nlm.nih.gov/pubmed/30915245 http://dx.doi.org/10.1155/2019/3510860 |
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