Cryptococcal meningitis in an immunocompetent child: a case report and literature review

Southeast Asian J Trop Med Public Health. 2004 Dec;35(4):930-4.

Abstract

An immunocompetent 5 year-old girl presented with pyrexia of unknown origin associated with headache. Initial investigations showed leukocytosis and an increased erythrocyte sedimentation rate. A Widal-Weil Felix test, blood film for malarial parasites, mycoplasma IgM antibody, cultures from blood and urine, full blood picture, Mantoux test, and chest x-ray were all negative. A lumbar puncture was done as part of a work-up for pyrexia of unknown origin. Cryptococcus neoformans was seen on India ink examination and confirmed on culture. She was treated with 10 weeks of intravenous amphotericin B and 8 weeks of fluconazole. Further immunological tests did not reveal any defect in the cell-mediated immune system. C. neoformans meningitis may present with non-specific symptoms and should be considered in a work-up for pyrexia of unknown origin.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Amphotericin B / therapeutic use
  • Antifungal Agents / therapeutic use
  • Child, Preschool
  • Cryptococcus neoformans / isolation & purification
  • Cryptococcus neoformans / pathogenicity
  • Female
  • Fluconazole / therapeutic use
  • Humans
  • Malaysia
  • Meningitis, Cryptococcal / diagnosis
  • Meningitis, Cryptococcal / drug therapy
  • Meningitis, Cryptococcal / physiopathology*

Substances

  • Antifungal Agents
  • Amphotericin B
  • Fluconazole