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Publication year
2015Source
Nederlands Tijdschrift voor Geneeskunde, 159, (2015), pp. A8478ISSN
Publication type
Article / Letter to editor
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Organization
Nephrology
Journal title
Nederlands Tijdschrift voor Geneeskunde
Volume
vol. 159
Page start
p. A8478
Subject
Radboudumc 11: Renal disorders RIHS: Radboud Institute for Health SciencesAbstract
Immunocompromised patients are at increased risk of disseminated cryptococcal infection, often presenting as a primary respiratory infection with yeast cells originating from bird excreta. Because Cryptococcus neoformans has a tropism for cerebrospinal fluid, most patients suffer from meningitis or meningoencephalitis. Symptoms of cryptococcal meningitis are non-specific: headache, fever, nausea, or altered mental state and behaviour. Case descriptions of a renal transplant recipient and an HIV patient illustrate the non-specific presentation of cryptococcal meningitis. Lumbar puncture seemed to be critical in establishing the diagnosis. Cerebrospinal fluid, blood and other tissues were tested for C. neoformans by microscopy, culture and antigen tests. The patients were successfully treated with amphotericin B or liposomal amphotericin B intravenously and flucytosine intravenously or orally, followed by long-term fluconazole. The mortality rate for cryptococcal meningitis is 41% among renal transplant recipients and 20% in HIV patients.
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- Academic publications [245263]
- Electronic publications [132514]
- Faculty of Medical Sciences [93208]
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