Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique
Immune deficiency is usually the underlying predisposing factor for cryptococcal meningitis, though there have been case reports of immunocompetent patients presenting with same. The portal of entry for Cryptococcus neoformans is the respiratory tract, and by hematogenous spread, it causes systemic...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2019/3510860 |
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| author | Chukwunonso Chime Charbel Ishak Kishore Kumar Muhammad Kamal Srinivasan Krishna Paul Kelly Sridhar Chilimuri |
| author_facet | Chukwunonso Chime Charbel Ishak Kishore Kumar Muhammad Kamal Srinivasan Krishna Paul Kelly Sridhar Chilimuri |
| author_sort | Chukwunonso Chime |
| collection | DOAJ |
| description | Immune deficiency is usually the underlying predisposing factor for cryptococcal meningitis, though there have been case reports of immunocompetent patients presenting with same. The portal of entry for Cryptococcus neoformans is the respiratory tract, and by hematogenous spread, it causes systemic symptoms. The presence of CSF leak is described to have predisposed our immunocompetent patient to infection by this organism possibly through direct spread. The gold standard for diagnosing CSF leak is by cisternography. In this case, we added a technique where nasal gauze is inserted during the procedure and scanned afterwards for dye, thus increasing the confidence of diagnosis of CSF leak through the nares. Prompt diagnosis and treatment is key to prevent adverse outcomes, and we propose that in patients with cryptococcal meningitis without any identifiable risk factor, evaluation for CSF leak should be considered especially with history of head trauma. |
| format | Article |
| id | doaj-art-fee56d1263d24877a66c4a0c21991306 |
| institution | Kabale University |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-fee56d1263d24877a66c4a0c219913062025-02-03T05:59:18ZengWileyCase Reports in Infectious Diseases2090-66252090-66332019-01-01201910.1155/2019/35108603510860Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic TechniqueChukwunonso Chime0Charbel Ishak1Kishore Kumar2Muhammad Kamal3Srinivasan Krishna4Paul Kelly5Sridhar Chilimuri6BronxCare Health System–A Clinical Affiliate of Mount Sinai Hospital and Academic Affiliate of the Icahn School of Medicine, New York, NY, USABronxCare Health System–A Clinical Affiliate of Mount Sinai Hospital and Academic Affiliate of the Icahn School of Medicine, New York, NY, USABronxCare Health System–A Clinical Affiliate of Mount Sinai Hospital and Academic Affiliate of the Icahn School of Medicine, New York, NY, USABronxCare Health System–A Clinical Affiliate of Mount Sinai Hospital and Academic Affiliate of the Icahn School of Medicine, New York, NY, USABronxCare Health System–A Clinical Affiliate of Mount Sinai Hospital and Academic Affiliate of the Icahn School of Medicine, New York, NY, USABronxCare Health System–A Clinical Affiliate of Mount Sinai Hospital and Academic Affiliate of the Icahn School of Medicine, New York, NY, USABronxCare Health System–A Clinical Affiliate of Mount Sinai Hospital and Academic Affiliate of the Icahn School of Medicine, New York, NY, USAImmune deficiency is usually the underlying predisposing factor for cryptococcal meningitis, though there have been case reports of immunocompetent patients presenting with same. The portal of entry for Cryptococcus neoformans is the respiratory tract, and by hematogenous spread, it causes systemic symptoms. The presence of CSF leak is described to have predisposed our immunocompetent patient to infection by this organism possibly through direct spread. The gold standard for diagnosing CSF leak is by cisternography. In this case, we added a technique where nasal gauze is inserted during the procedure and scanned afterwards for dye, thus increasing the confidence of diagnosis of CSF leak through the nares. Prompt diagnosis and treatment is key to prevent adverse outcomes, and we propose that in patients with cryptococcal meningitis without any identifiable risk factor, evaluation for CSF leak should be considered especially with history of head trauma.http://dx.doi.org/10.1155/2019/3510860 |
| spellingShingle | Chukwunonso Chime Charbel Ishak Kishore Kumar Muhammad Kamal Srinivasan Krishna Paul Kelly Sridhar Chilimuri Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique Case Reports in Infectious Diseases |
| title | Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique |
| title_full | Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique |
| title_fullStr | Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique |
| title_full_unstemmed | Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique |
| title_short | Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique |
| title_sort | cryptococcal meningitis in a hiv seronegative patient a rare complication of cerebrospinal fluid leak detected with a new cisternographic technique |
| url | http://dx.doi.org/10.1155/2019/3510860 |
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