Horton Embrey Pamela, Long Alexandra, Alfattal Rasha, Qiu Suimin, Hornak Joseph Patrik
University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX 77555, USA.
University of Texas Medical Branch at Galveston, Galveston, TX, USA.
Ther Adv Infect Dis. 2024 Feb 7;11:20499361241230149. doi: 10.1177/20499361241230149. eCollection 2024 Jan-Dec.
Cryptococcal infections, though rare, must be considered in all immunocompromised patients. Patients with HIV/AIDS on antiretrovirals may have a treatment course complicated by immune reconstitution inflammatory syndrome. Here we present a case of a 38-year-old woman with HIV/AIDS with knee pain who only began to experience severe pain after induction of antiretroviral therapy. She was found to have cryptococcal osteomyelitis without dissemination to the central nervous system, an unusual presentation for immunocompromised patients. She was treated with oral fluconazole with a resolution of symptoms. This case report suggests conservative management of isolated cryptococcal infection with fluconazole, regardless of immune status.
隐球菌感染虽然罕见，但所有免疫功能低下的患者都必须考虑到。接受抗逆转录病毒治疗的艾滋病毒/艾滋病患者的治疗过程可能会因免疫重建炎症综合征而变得复杂。在此，我们报告一例38岁患有艾滋病毒/艾滋病且膝盖疼痛的女性病例，她在开始抗逆转录病毒治疗后才开始出现剧痛。她被诊断为隐球菌性骨髓炎，未扩散至中枢神经系统，这在免疫功能低下的患者中是一种不寻常的表现。她接受了口服氟康唑治疗，症状得到缓解。本病例报告表明，无论免疫状态如何，对于孤立的隐球菌感染，用氟康唑进行保守治疗是可行的。
