Villafuerte David B, Passeri Marco F, Qazi Rayan, Baireddy Moulika, Sanchez Fernando L
University of the Incarnate Word School of Osteopathic Medicine, Laredo Medical Center, 1700 E Saunders St, Laredo, TX 78041, USA.
Case Rep Infect Dis. 2022 Feb 21;2022:2000246. doi: 10.1155/2022/2000246. eCollection 2022.
is a microscopic fungus that despite its pervasiveness in the environment rarely causes infection in immunocompetent patients. In immunosuppressed patients, infections involving the central nervous system (CNS) usually present as meningitis or meningoencephalitis. Cryptococcal infections are known to cause significant morbidity and mortality in immunosuppressed patients as it is difficult to eradicate even with adequate antifungal treatment. A 44-year-old Hispanic male presented to the hospital with headache, progressive urinary retention, neck and back pain, and right upper and bilateral lower extremity weakness for five days. Imaging revealed small foci in the white matter and revealed diffuse abnormal signal involving the cervical medullary junction extending up to the thoracic spine. Analysis of cerebral spinal fluid (CSF) obtained via lumbar puncture was positive for the antigen with cultures also growing . Upon evaluation, patient was not found to be immunocompromised. This report works to highlight an atypical presentation of a cryptococcal CNS infection to raise awareness amongst clinicians hoping to prevent a delay in diagnosis of this disease given its high mortality.
是一种微观真菌，尽管它在环境中普遍存在，但在免疫功能正常的患者中很少引起感染。在免疫抑制患者中，累及中枢神经系统（CNS）的感染通常表现为脑膜炎或脑膜脑炎。已知隐球菌感染在免疫抑制患者中会导致显著的发病率和死亡率，因为即使进行充分的抗真菌治疗也难以根除。一名44岁的西班牙裔男性因头痛、进行性尿潴留、颈部和背部疼痛以及右上和双侧下肢无力五天而入院。影像学检查显示白质中有小病灶，并显示出累及颈髓交界处直至胸椎的弥漫性异常信号。通过腰椎穿刺获得的脑脊液（CSF）分析显示 抗原呈阳性，培养物中也生长出 。经评估，未发现患者有免疫功能低下。本报告旨在强调隐球菌中枢神经系统感染的非典型表现，以提高临床医生的认识，鉴于其高死亡率，希望能防止该病诊断延误。
