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Case Reports
. 2014 May;29(3):370-4.
doi: 10.3904/kjim.2014.29.3.370. Epub 2014 Apr 29.

Cryptococcal meningitis in a patient with chronic hepatitis C treated with pegylated-interferon and ribavirin

Tae-Hee Lee  1 , Kee-Ook Lee  2 , Yong-Seok Kim  1 , Sun-Moon Kim  1 , Kyu-Chan Huh  1 , Young-Woo Choi  1 , Young-Woo Kang  1
Affiliations
Case Reports

Cryptococcal meningitis in a patient with chronic hepatitis C treated with pegylated-interferon and ribavirin

Tae-Hee Lee et al. Korean J Intern Med. 2014 May.

Abstract

Various adverse events have been reported during combination therapy with pegylated (PEG)-interferon-α and ribavirin, although opportunistic infections, especially cryptococcal meningitis, are very rare. A 61-year-old woman complained of headaches and a fever during treatment of a chronic hepatitis C virus (HCV) infection. She had been treated for 7 months. Her headaches were refractory to analgesics, and she developed subtle nuchal rigidity. The cerebral spinal fluid (CSF) revealed a white blood cell count of 205/mm(3), 51 mg/dL protein, 35 mg/dL glucose, and negative Cryptococcus antigen. The CSF culture resulted in no growth. Five days later, the CSF was positive for Cryptococcus antigen. We administered amphotericin B and flucytosine, followed by fluconazole. Approximately 2 months later, she was discharged. For the first time, we report a case of cryptococcal meningitis during the treatment of chronic HCV with PEG-interferon-α and ribavirin.

Keywords: Cryptococcus; Hepatitis C; Meningitis; PEG-interferon-α; Ribavirin.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Overall clinical course. BT, body temperature; VAS, visual analogue scale; ACV, Acyclovir + Ceftriaxone + Vancomycin; HD, hospital day; CSF, cerebrospinal fluid; WBC, white blood cell; CBC, complete blood count.
See this image and copyright information in PMC

References

    1. Kwon-Chung KJ, Sorrell TC, Dromer F, Fung E, Levitz SM. Cryptococcosis: clinical and biological aspects. Med Mycol. 2000;38(Suppl 1):205–213. - PubMed
    1. Netea MG, Brouwer AE, Hoogendoorn EH, et al. Two patients with cryptococcal meningitis and idiopathic CD4 lymphopenia: defective cytokine production and reversal by recombinant interferon-gamma therapy. Clin Infect Dis. 2004;39:e83–e87. - PubMed
    1. Vander T, Medvedovsky M, Hallevy C, Golzman G, Herishanu Y. Listeria monocytogenes meningitis in a patient with chronic hepatitis C infection, treated by interferon alfa and ribavirin. J Infect. 2003;46:70–71. - PubMed
    1. Hadem J, Cornberg M, Hauptmann C, Suttmann U, Manns MP, Wedemeyer H. Pneumococcal meningitis during antiviral treatment with interferon and ribavirin in a splenectomized patient with chronic hepatitis C: do not miss vaccination before starting therapy. Z Gastroenterol. 2008;46:880–882. - PubMed
    1. Hoofnagle JH, Seeff LB. Peginterferon and ribavirin for chronic hepatitis C. N Engl J Med. 2006;355:2444–2451. - PubMed

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