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Case Reports
. 2022 Nov 7:38:44-47.
doi: 10.1016/j.mmcr.2022.10.006. eCollection 2022 Dec.

Distal jejunal obstruction due to Cryptococcus neoformans and rifampicin-resistant Mycobacterium tuberculosis co-infection: A case report

John Kasibante  1 , Enock Kagimu  1 , Morris K Rutakingirwa  1 , Samuel Jjunju  1 , Lillian Tugume  1 , David B Meya  1
Affiliations
Case Reports

Distal jejunal obstruction due to Cryptococcus neoformans and rifampicin-resistant Mycobacterium tuberculosis co-infection: A case report

John Kasibante et al. Med Mycol Case Rep. .

Abstract

Jejunal obstruction secondary to Cryptococcus neoformans and rifampicin-resistant Mycobacterium tuberculosis co-infection in HIV is not previously reported. This is a case of a 30-year-old HIV-positive male with severe headaches, a positive cerebrospinal fluid cryptococcal antigen assay, and elevated intracranial pressure requiring serial lumbar punctures and opioids. He developed constipation and abdominal distension, had partial jejunectomy and histopathology revealed Cryptococcus yeasts and caseous granulomas with Mycobacterium tuberculosis (TB). Post-operatively, rifampicin-resistant TB was detected in urine.

Keywords: Cryptococcal-TB co-Infection; HIV; Intestinal cryptococcosis; Jejunal obstruction; Rifampicin resistance.

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Conflict of interest statement

“There are none.”

Figures

Fig. 1
Fig. 1
Biopsy staining showing Cryptococcus neoformans on Periodic acid–Schiff (PAS) and Hematoxylin and eosin (H&E) stain. White clearing represents cryptococcal polysaccharide capsule. (A) x40 objective magnification PAS-stained sections showing cystic areas containing C. neoformans. (B) x20 objective magnification H&E staining showing cystic areas containing C. neoformans. (C) x10 magnification H&E staining showing cystic areas containing C. neoformans.
Fig. 2
Fig. 2
Jejunal biopsy staining showing acid-fast bacilli staining, granulomas and giant cells, consistent with Mycobacterium tuberculosis infection. (A) x40 objective magnification Ziehl-Neelsen staining shows positively stained bacilli. (B) x10 objective magnification Hematoxylin and eosin (H&E) stain showing areas of necrosis and granuloma formation. (C) x20 objective magnification H&E stained sections showing granuloma formation with multinucleate giant cells.
See this image and copyright information in PMC

References

    1. Kaplan R., Hermans S., Caldwell J., Jennings K., Bekker L.-G., Wood R. HIV and TB co-infection in the ART era: CD4 count distributions and TB case fatality in Cape Town. BMC Infect. Dis. 2018;18(1):356. - PMC - PubMed
    1. Rajasingham R., Smith R.M., Park B.J., Jarvis J.N., Govender N.P., Chiller T.M., et al. Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis. Lancet Infect. Dis. 2017;17(8):873–881. - PMC - PubMed
    1. Rutakingirwa M.K., Cresswell F.V., Kwizera R., Ssebambulidde K., Kagimu E., Nuwagira E., et al. Tuberculosis in HIV-associated cryptococcal meningitis is associated with an increased risk of death. J. Clin. Med. 2020;9(3) - PMC - PubMed
    1. WHO . World Health Organization; Geneva: 2020. WHO Operational Handbook on Tuberculosis. Module 1: Prevention - Tuberculosis Preventive Treatment.https://appswhoint/iris/rest/bitstreams/1272664/retrieve. 2020 Licence: CC BY-NC-SA 3.0 IGO. - PubMed
    1. Denham S.T., Brown J.C.S. Mechanisms of pulmonary escape and dissemination by cryptococcus neoformans. J Fungi (Basel) 2018;4(1):25. - PMC - PubMed

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