Mixed infection by Cryptococcus neoformans and Cryptococcus gattii and coinfection with paracoccidioidomycosis in PLHIV

Marcela de Faria Ferreira; Fabio Brito-Santos; Pedro Henrique Nascimento Theodoro; Marcos de Abreu Almeida; Marcia Dos Santos Lazera; Luciana Trilles

doi:10.1016/j.mmcr.2022.01.006

Mixed infection by Cryptococcus neoformans and Cryptococcus gattii and coinfection with paracoccidioidomycosis in PLHIV

Med Mycol Case Rep. 2022 Jan 27:35:48-50. doi: 10.1016/j.mmcr.2022.01.006. eCollection 2022 Mar.

Authors

Marcela de Faria Ferreira¹, Fabio Brito-Santos², Pedro Henrique Nascimento Theodoro¹, Marcos de Abreu Almeida¹, Marcia Dos Santos Lazera¹, Luciana Trilles¹

Affiliations

¹ National Institute of Infectious Disease Evandro Chagas, Oswaldo Cruz Foundation, Rio de Janeiro, 21040-900, Brazil.
² Oswaldo Cruz Institute (IOC), Oswaldo Cruz Foundation, Rio de Janeiro, 21040-900, Brazil.

Abstract

We present a rare condition of mixed C. neoformans and C. gattii infection in a person living with HIV with false-negative CrAg LFA in the CSF and co-infection with paracoccidioidomycosis. Signs and symptoms are relative to respiratory tract and skin, confounding with other opportunistic disease. After negatives CrAg LFA and Indian ink staining in CSF, there was isolation of C. gattii in sputum and C. neoformans in CSF, in addition to reagent serology (double immunodiffusion) for PCM with 1/16 titer. The patient was treated with amphotericin B and TMP-SMX with good clinical response and recovery of cellular immunity after initiation of antiretroviral therapy.

Keywords: Cryptococcal antigen (CrAg); Cryptococcosis; HIV; Lateral Flow Assay (LFA); Paracoccidioidomycosis.

Publication types

Case Reports