Singh Shalini, Hajra Subhajit, Kumar Vinod, Balasubramanian Priyavadhana
Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, AIIMS, Rishikesh, Uttarakhand, India.
Department of Pediatrics, All India Institute of Medical Sciences, AIIMS, Rishikesh, Uttarakhand, India.
Indian J Pathol Microbiol. 2024 Sep 14. doi: 10.4103/ijpm.ijpm_157_24.
Cryptococcal infection is less common in immunocompetent hosts and almost always occurs in the setting of HIV disease. Disseminated Cryptococcosis in a child is a fatal condition and often requires a prompt diagnosis and appropriate antifungal therapy to improve patient outcomes. Here, we present a case of bone marrow Cryptococcal infection in a 4-year-old female child. She presented clinically with fever, abdominal pain, and hepatosplenomegaly for a duration of two and a half months. A bone marrow aspiration and trephine biopsy was performed with a suspicion of haemato-lymphoid malignancy. However, bone marrow aspirate smears revealed bone marrow Cryptococcosis which was later confirmed by special stains. She was treated with liposomal amphotericin B (3 mg/kg) and flucytosine (100 mg/kg/day). A comprehensive approach including clinical symptoms, examination findings, imaging studies, and laboratory tests is crucial in establishing an early diagnosis of Cryptococcosis, particularly with atypical presentations.
隐球菌感染在免疫功能正常的宿主中较少见，几乎总是发生在艾滋病患者中。儿童播散性隐球菌病是一种致命疾病，通常需要及时诊断和适当的抗真菌治疗以改善患者预后。在此，我们报告一例4岁女童骨髓隐球菌感染病例。她临床上表现为发热、腹痛和肝脾肿大，持续两个半月。因怀疑血液淋巴系统恶性肿瘤而行骨髓穿刺和环钻活检。然而，骨髓穿刺涂片显示为骨髓隐球菌病，随后经特殊染色得以确诊。她接受了脂质体两性霉素B（3mg/kg）和氟胞嘧啶（100mg/kg/天）治疗。包括临床症状、检查结果、影像学检查和实验室检查在内的综合方法对于隐球菌病的早期诊断至关重要，尤其是对于非典型表现的病例。
