The first case of cryptococcal meningitis in a Swedish patient with AIDS
Karlsson, M.; Lidman, K.; Philipson, A.; Berglund, O.; Carlsson, B.; Karlsson, A.
Lakartidningen 83(46): 3918-3920
1986
ISSN/ISBN: 0023-7205 PMID: 3807479 Document Number: 272204
A case in a 48-yr-old bisexual man is reported. The patient was originally referred to an infectious disease clinic because of fatigue and fever. A lumbar puncture taken 2 yrs previously had revealed a slight increase in protein levels and leukocyte count. A lumbar puncture taken 6 months later indicated immunodeficiency, but no pathogenic organisms were detected in the cerebrospinal fluid (CSF) at that time. The patient remained febrile and also developed neurological systems indicative of meningitis. A further lumbar puncture revealed a further increase in the leukocyte count and Cryptococcus neoformans was isolated from cultures of CSF. The patient was treated with amphotericin B, but after 2 courses this was discontinued due to renal dysfunction, although the infection appeared to be responding to treatment. The patient died 5 months later from Pneumocystis carinii infection. Post-mortem examination revealed no macroscopic signs of meningitis, but large numbers of C. neoformans organisms were demonstrated in microscopic examination of the meninges.