Journal of Clinical Pathology 2008;61:1138-1139
CASE REPORTS
Cryptococcus meningitis and skin lesions in an HIV negative child
1 Department of Microbiological Pathology, Inkosi Albert Luthuli Central Hospital, National Health Laboratory Service, South Africa
2 Department of Pediatrics, Stanger Hospital, South Africa
Dr K Swe Swe/Han, Pathology Building, 4th floor, Medical Microbiology Department, National Health Laboratory Service, No. 800, Bellair Road, Cato Manor, 4058, Durban, South Africa; arthurhan{at}absamail.co.za
Disseminated cryptococcosis is an uncommon occurrence in immunocompetent populations and occurs mainly in immunocompromised patients. The first case of cryptococcus meningitis and skin lesions in a 4-year-old confirmed HIV negative boy who presented with fever, meningism and skin lesions is reported. On examination the child was confused, uncooperative, and had neck stiffness and raised skin lesions. A septic screen, including skin scraping, was performed; the child was treated with penicillin and ceftriaxone for suspected meningococcal meningitis. The cerebrospinal fluid (CSF) had normal protein, glucose and chloride levels; yeasts were observed on Gram stain from the CSF and skin scraping. The India ink stain and Cryptococcus neoformans latex agglutination test on the CSF were both positive. Bacterial culture of the skin biopsy, CSF and blood culture specimens was negative. The child was treated with amphotericin B based on preliminary results, and had a gradual recovery with no neurological sequelae. The child continued oral fluconazole.
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Compound via MeSHSubstance via MeSHHazardous Substances DB AMPHOTERICIN B
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Meningitis
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Infection (neurology)
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Immunology (including allergy)
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HIV/AIDS
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Sexual transmitted infections (viral)
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