Cryptococcal meningitis in an immunocompetent child: a case report and literature review
Othman, N.; Abdullah, N.Atiqah.Ng.; Wahab, Z.Abdul.
Southeast Asian Journal of Tropical Medicine and Public Health 35(4): 930-934
2004
ISSN/ISBN: 0125-1562 PMID: 15916093 Document Number: 580334
An immunocompetent 5 year-old girl presented with pyrexia of unknown origin associated with headache. Initial investigations showed leukocytosis and an increased erythrocyte sedimentation rate. A Widal-Weil Felix test, blood film for malarial parasites, mycoplasma IgM antibody, cultures from blood and urine, full blood picture, Mantoux test, and chest x-ray were all negative. A lumbar puncture was done as part of a work-up for pyrexia of unknown origin. Cryptococcus neoformans was seen on India ink examination and confirmed on culture. She was treated with 10 weeks of intravenous amphotericin B and 8 weeks of fluconazole. Further immunological tests did not reveal any defect in the cell-mediated immune system. C. neoformans meningitis may present with non-specific symptoms and should be considered in a work-up for pyrexia of unknown origin.