Résumé
Introduction@#Cryptococcus neoformans (C. neoformans) is a fungus which infects the lungs, meninges, skin and the nervous system. In tropical countries prevalent with tuberculosis (TB), initial clinical presentations of a C. neoformans infection can normally be mistaken as a TB infection. The C. neoformans infection shall then form part of the differential diagnosis. Exposure to C. neoformans does not usually manifest as an infection however, in immunocompromised patients this results to cryptococcosis.@*Case@#This is a case of a 33-year-old male who was admitted due to febrile seizures. He was suspected to be in an immunocompromised state due to multiple sexual partners. A non-tender, mobile left cervical lymphadenopathy was subjected to FNAB (fine needle aspiration biopsy) surprisingly came out to be cryptococcal in nature. He was managed as a case of disseminated cryptococossis with meningeal extension. He was given amphotericin B and fluconazole.@*Conclusion@#The most common suspected cause of lymphadenitis in the Philippines is attributed to TB. The high index of suspicion based on sound medical history and physical examination can lead the clinician into considering an uncommon cause of lymphadenopathy most especially in patients with high likelihood of immunocompromised state.
Sujets)
Cryptococcose , Méningite cryptococcique , VIH (Virus de l'Immunodéficience Humaine)Résumé
Cryptococcus neoformans is an organism that mainly causes opportunistic infection in immunocompromised patients. It can also cause various infections in immunocompetent patients, but cryptococcal lymphadenitis is rare. We have experienced a case of cryptococcal lymphadenitis in an immunocompetent adult patient who presented with cervical lymphadenopathy and fever that did not subside for 3 weeks. Neck and chest CT scan showed multiple lymph node enlargements with central low density and peripheral enhancement on both hilar, mediastinal, and right supraclavicular areas. Cryptococcus lymphadenitis was diagnosed by tissue biopsy, PAS and GMS stain, and culture. This case emphasizes that when an immunocompetent patient presents with lymphadenopathy, cryptococcal lymphadenitis should always be considered in the differential diagnosis.
Sujets)
Adulte , Humains , Biopsie , Cryptococcus , Cryptococcus neoformans , Diagnostic différentiel , Fièvre , Sujet immunodéprimé , Noeuds lymphatiques , Lymphadénite , Maladies lymphatiques , Cou , Infections opportunistes , TomodensitométrieRésumé
Cryptococcus neoformans is an organism that mainly causes opportunistic infection in immunocompromised patients. It can also cause various infections in immunocompetent patients, but cryptococcal lymphadenitis is rare. We have experienced a case of cryptococcal lymphadenitis in an immunocompetent adult patient who presented with cervical lymphadenopathy and fever that did not subside for 3 weeks. Neck and chest CT scan showed multiple lymph node enlargements with central low density and peripheral enhancement on both hilar, mediastinal, and right supraclavicular areas. Cryptococcus lymphadenitis was diagnosed by tissue biopsy, PAS and GMS stain, and culture. This case emphasizes that when an immunocompetent patient presents with lymphadenopathy, cryptococcal lymphadenitis should always be considered in the differential diagnosis.