Cryptococcal meningitis presenting as sinusitis in a renal transplant recipient

Transpl Infect Dis. 2013 Oct;15(5):E187-90. doi: 10.1111/tid.12128. Epub 2013 Aug 27.

Abstract

Cryptococcal meningitis is a relatively common invasive fungal infection in immunocompromised patients, especially in solid organ transplant recipients. Clinical presentation typically includes fever, headache, photophobia, neck stiffness, and/or altered mental status. Unusual presentations may delay diagnosis. Therapy is challenging in renal transplant patients because of the nephrotoxicity associated with amphotericin B, the recommended treatment. We present a case of cryptococcal meningitis in a renal transplant recipient presenting as acute sinusitis with successful treatment using fluconazole as primary therapy.

Keywords: Cryptococcus; meningitis; renal transplantation; sinusitis.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / therapeutic use*
  • Cryptococcus neoformans / drug effects
  • Cryptococcus neoformans / immunology
  • Cryptococcus neoformans / isolation & purification*
  • Diagnosis, Differential
  • Female
  • Fluconazole / therapeutic use*
  • Humans
  • Immunocompromised Host
  • Kidney Transplantation / adverse effects*
  • Meningitis, Cryptococcal / diagnosis*
  • Meningitis, Cryptococcal / drug therapy
  • Meningitis, Cryptococcal / microbiology
  • Middle Aged
  • Sinusitis / diagnosis*
  • Sinusitis / drug therapy
  • Sinusitis / microbiology

Substances

  • Antifungal Agents
  • Fluconazole