Department of Internal Medicine, Military Hospital, Tunis, Tunisia.
Laboratory of Hematology, Military Hospital, Tunis, Tunisia.
Pan Afr Med J. 2020 Aug 21;36:324. doi: 10.11604/pamj.2020.36.324.20407. eCollection 2020.
Rare cases of Cryptococcus have been documented in patients living with multiple myeloma. To date there has been no documented evidence of cryptococcosis revealing multiple myeloma. We reported a 63-year-old man who had a 2-months history continuous holocranial headaches, morning vomiting, complaining of blurred vision and fever. The biologic and the imaging showed a Cryptococcus meningoencephalitis. The search for a cause of immunodeficiency revealed a multiple myeloma. The diagnosis for Cryptococcus was confirmed according to an India ink stain, blood and cerebrospinal fluid culture. The patient's treatment for multiple myeloma was initiated with a chemotherapy regimen. The evolution was good without complication. Cryptococcosis, especially in the neuro-meningeal form, is a serious, deadly opportunistic infection. The search of an underlining immunodeficiency must be systematic. In this case, it was associated with early stage multiple myeloma.
已有文献记录了一些多发性骨髓瘤患者合并新型隐球菌感染的罕见病例。但目前尚无隐球菌病揭示多发性骨髓瘤的相关报道。我们报告了一例 63 岁男性患者,其病史为持续全颅头痛 2 个月,晨吐,伴有视力模糊和发热。实验室和影像学检查提示新型隐球菌性脑膜脑炎。寻找免疫缺陷的病因时发现了多发性骨髓瘤。新型隐球菌的诊断依据墨汁染色、血和脑脊液培养结果。该患者开始接受多发性骨髓瘤的化疗方案治疗。病情进展良好,无并发症。新型隐球菌病,尤其是神经脑膜形式,是一种严重的、致命的机会性感染。必须系统地寻找潜在的免疫缺陷。在本例中,它与早期多发性骨髓瘤相关。