Rohilla Ranjana, Meena Suneeta, Kaistha Neelam, Krishna Raj Anusha, Gupta Pratima
Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Curr Med Mycol. 2019;5(4):50-53. doi: 10.18502/cmm.5.4.2163.
We report a case of disseminated cryptococcosis in a treatment-naïve patient, incidentally diagnosed with hepatitis C virus (HCV) infection and renal parenchymal disease. The patient succumbed to death given the very late diagnosis of the disease.
A 54-year-old male presented with the chief complaints of abdominal pain, chest pain, and phlegmy cough for a month. There was a past history of decreased urine output, lower limb swelling, and fever lasting for 15-20 days. After a general physical examination, the differential diagnosis of hepatitis C-related liver disease with hepatic encephalopathy, disseminated tuberculosis, and septic shock was made. Radiological examination revealed renal parenchymal disease on ultrasound abdomen and opacity with reticulonodular opacity in the bilateral lung zones. In laboratory investigations, serum reactive sample was tested for anti-HCV antibodies. In addition, was identified in blood culture using the matrix-assisted laser desorption ionization-time of flight mass spectrometry (Bruker Daltonics, Germany). The patient succumbed to death before the initiation of any specific antifungal therapy.
Cryptococcosis-HCV co-infection is a fatal condition with a fulminant course that might be difficult to treat.
我们报告一例初治患者的播散性隐球菌病病例,该患者意外诊断为丙型肝炎病毒(HCV)感染和肾实质疾病。由于疾病诊断非常晚,患者最终死亡。
一名54岁男性,主要主诉为腹痛、胸痛和咳痰1个月。既往有尿量减少、下肢肿胀和发热病史,持续15 - 20天。经过全面体格检查,考虑鉴别诊断为丙型肝炎相关肝病伴肝性脑病、播散性结核病和感染性休克。腹部超声检查显示肾实质疾病,双侧肺野可见网状结节状模糊影。实验室检查中,检测血清反应性样本中的抗HCV抗体。此外,使用基质辅助激光解吸电离飞行时间质谱(德国布鲁克道尔顿公司)在血培养中鉴定出 。在开始任何特异性抗真菌治疗之前,患者死亡。
隐球菌病 - HCV合并感染是一种致命疾病,病程凶险,可能难以治疗。