Simultaneous cryptococcal and tuberculous meningitis in a patient with systemic lupus erythematosus

J Microbiol Immunol Infect. 2016 Apr;49(2):289-94. doi: 10.1016/j.jmii.2013.04.009. Epub 2013 Jun 7.

Abstract

Simultaneous central nervous system (CNS) infection with Cryptococcus and tuberculosis (TB) is very rare. Despite improved therapeutic options, treatment of CNS cryptococcosis is still difficult and needs invasive treatment modalities, such as intrathecal or intraventricular amphotericin B, in refractory cases. We describe a patient with systemic lupus erythematosus diagnosed with simultaneous cryptococcal and TB meningitis who had a poor response to intravenous liposomal amphotericin B and fluconazole, but was successfully treated with intraventricular amphotericin B, in addition to anti-TB therapy.

Keywords: Cryptococcus; Intraventricular amphotericin B; Meningitis; Tuberculosis.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravenous
  • Amphotericin B / administration & dosage
  • Antifungal Agents / administration & dosage
  • Antitubercular Agents / administration & dosage
  • Female
  • Fluconazole / administration & dosage
  • Humans
  • Infusions, Intraventricular
  • Lupus Erythematosus, Systemic / complications*
  • Meningitis, Cryptococcal / complications*
  • Meningitis, Cryptococcal / diagnosis*
  • Meningitis, Cryptococcal / pathology
  • Middle Aged
  • Treatment Outcome
  • Tuberculosis, Meningeal / complications*
  • Tuberculosis, Meningeal / diagnosis*
  • Tuberculosis, Meningeal / pathology

Substances

  • Antifungal Agents
  • Antitubercular Agents
  • liposomal amphotericin B
  • Amphotericin B
  • Fluconazole