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Case Reports
. 2010 Nov 25;15(11):504-6.
doi: 10.1186/2047-783x-15-11-504.

A fatal case of AIDS-defining meningoencephalitis by C. neoformans, sensitive to antifungal therapy

S Mohammad-Khani  1 , B Otremba, R Klein, H H Capelle, F Logemann, F C Bange, R E Schmidt, M Stoll
Affiliations
Case Reports

A fatal case of AIDS-defining meningoencephalitis by C. neoformans, sensitive to antifungal therapy

S Mohammad-Khani et al. Eur J Med Res. .

Abstract

Cryptococcus neoformans is the most common cause of life threatening meningoencephalitis in HIV-infected patients. Diagnosis is based on tests for cryptoccocal antigen in serum and cerebrospinal fluid, and on culture of the organism. We present a case of AIDS-related cryptococcal meningoencephalitis unresponsive to antifungal combination therapy, despite of evidence of fungal susceptibility in vitro. Significant decreases in cryptococcal antigen titers in serum and cerebrospinal fluid did not correlate with progress in disease and fatal outcome.

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Figures

Figure 1
Figure 1
Series of cerebral images in the course of infection. A) cerebral MRI 3 weeks prior to admission; B) MRI on admission with bihemispheric mass right more than left in basal ganglia area (arrow); C) Cerebral CT after 3 weeks of antifungal combination therapy with loss of gray-white distinction and effacement of cerebral sulci.
Figure 2
Figure 2
Brain tissue infection with encapsulated C. neoformans appears as bubbles due to gelatinous capsules. Reproducing by budding (arrow) PAS-stain, magnification, ×400.
Figure 3
Figure 3
Course of serum cryptococal antigen titer, antifungal antigen titer, antifungal combination therapy, ICP controlling therapy and the course of disease.
See this image and copyright information in PMC

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