Concurrent cryptococcal meningitis and falciparum malaria in a child with nephrotic syndrome
Mirdha, B.R.; Sarkar, T.; Banerjee, U.; Sethi, S.; Dan, G.; Xess, I.
Indian Pediatrics 35(4): 360-363
1998
ISSN/ISBN: 0019-6061 PMID: 9770893 Document Number: 493126
A case is reported in a 15-year-old boy from New Delhi, India with a 1-week history of headache, vomiting, intermittent fever, chills and rigour. The patient had been receiving prednisone treatment for nephrotic syndrome, diagnosed 3 years earlier. Microbiological examination of cerebrospinal fluid revealed Gram-variable spherical budding yeast cells and cultures grew Cryptococcus neoformans. Giemsa-stained peripheral blood smear showed asexual and sexual stages of Plasmodium falciparum. The patient was treated with a combination of sulfadoxine (20 mg/kg) and pyrimethamine (1 mg/kg) for the P. falciparum infection and amphotericin B (0.3 mg/kg then 0.5 mg/kg) was given in combination with flucytosine (100 mg/kg) for the cryptococcosis. After culture became negative for C. neoformans, therapy was changed to fluconazole (200 mg/day) and the patient was discharged. P. falciparum was not detected on repeated peripheral blood smears.