Pediatric Cryptococcal Lymphadenitis in the Absence of AIDS: Case Report and Literature Review

We present a rare case of cryptococcal lymphadenitis without immunocompromization in a two-and-a-half-year-old child. He was referred to our center with a fifteen-day history of continued fever. Ultrasound and computed tomography (CT) revealed the enlargement of multiple lymph nodes and lung reticul...

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Main Authors: Fengchang Bao, Hongna Tan, Wei Liu, Yange Li, Huixia Li
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2013/563081
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author Fengchang Bao
Hongna Tan
Wei Liu
Yange Li
Huixia Li
author_facet Fengchang Bao
Hongna Tan
Wei Liu
Yange Li
Huixia Li
author_sort Fengchang Bao
collection DOAJ
description We present a rare case of cryptococcal lymphadenitis without immunocompromization in a two-and-a-half-year-old child. He was referred to our center with a fifteen-day history of continued fever. Ultrasound and computed tomography (CT) revealed the enlargement of multiple lymph nodes and lung reticulonodular shadows. Hematological, immunological, and microbiological tests for hepatitis, lymphoma, AIDS, and immunoglobulin deficiencies were negative. Laboratory tests demonstrated elevated erythrocyte sedimentation rate, elevated plasma and urinary ß2-microglobulin (ß2-MG) levels, and elevated C-reactive protein and fibrinogen. Both blood routine and bone marrow aspiration showed elevated eosinophil granulocytes. The diagnosis of cryptococcal lymphadenitis was obtained by excisional biopsy of the cervical lymph nodes. The patient was treated with intravenous amphotericin B and oral flucytosine for five weeks, then with subsequent oral fluconazole for three months. The patient is now doing well. Our case suggests that the diagnosis of cryptococcal lymphadenitis is very difficult without etiology and pathology, especially for a patient with a normal immune system; lymph node biopsy is necessary to diagnose it, and immediate antifungal treatment is necessary to treat it.
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spelling doaj-art-abdca6bd65594527a9c66e3fa0db100d2025-08-20T02:20:13ZengWileyCase Reports in Pediatrics2090-68032090-68112013-01-01201310.1155/2013/563081563081Pediatric Cryptococcal Lymphadenitis in the Absence of AIDS: Case Report and Literature ReviewFengchang Bao0Hongna Tan1Wei Liu2Yange Li3Huixia Li4Department of Hematology, Children’s Hospital, Zhengzhou, 255 Gangdu Road, Henan 450052, ChinaDepartment of Radiology, The First Affilicated Hospital of Zhengzhou University, Zhengzhou, 1 Jianshe East Road, Henan 450000, ChinaDepartment of Hematology, Children’s Hospital, Zhengzhou, 255 Gangdu Road, Henan 450052, ChinaDepartment of Hematology, Children’s Hospital, Zhengzhou, 255 Gangdu Road, Henan 450052, ChinaDepartment of Hematology, Children’s Hospital, Zhengzhou, 255 Gangdu Road, Henan 450052, ChinaWe present a rare case of cryptococcal lymphadenitis without immunocompromization in a two-and-a-half-year-old child. He was referred to our center with a fifteen-day history of continued fever. Ultrasound and computed tomography (CT) revealed the enlargement of multiple lymph nodes and lung reticulonodular shadows. Hematological, immunological, and microbiological tests for hepatitis, lymphoma, AIDS, and immunoglobulin deficiencies were negative. Laboratory tests demonstrated elevated erythrocyte sedimentation rate, elevated plasma and urinary ß2-microglobulin (ß2-MG) levels, and elevated C-reactive protein and fibrinogen. Both blood routine and bone marrow aspiration showed elevated eosinophil granulocytes. The diagnosis of cryptococcal lymphadenitis was obtained by excisional biopsy of the cervical lymph nodes. The patient was treated with intravenous amphotericin B and oral flucytosine for five weeks, then with subsequent oral fluconazole for three months. The patient is now doing well. Our case suggests that the diagnosis of cryptococcal lymphadenitis is very difficult without etiology and pathology, especially for a patient with a normal immune system; lymph node biopsy is necessary to diagnose it, and immediate antifungal treatment is necessary to treat it.http://dx.doi.org/10.1155/2013/563081
spellingShingle Fengchang Bao
Hongna Tan
Wei Liu
Yange Li
Huixia Li
Pediatric Cryptococcal Lymphadenitis in the Absence of AIDS: Case Report and Literature Review
Case Reports in Pediatrics
title Pediatric Cryptococcal Lymphadenitis in the Absence of AIDS: Case Report and Literature Review
title_full Pediatric Cryptococcal Lymphadenitis in the Absence of AIDS: Case Report and Literature Review
title_fullStr Pediatric Cryptococcal Lymphadenitis in the Absence of AIDS: Case Report and Literature Review
title_full_unstemmed Pediatric Cryptococcal Lymphadenitis in the Absence of AIDS: Case Report and Literature Review
title_short Pediatric Cryptococcal Lymphadenitis in the Absence of AIDS: Case Report and Literature Review
title_sort pediatric cryptococcal lymphadenitis in the absence of aids case report and literature review
url http://dx.doi.org/10.1155/2013/563081
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