Imported cryptococcal infection mimicking primary sclerosing cholangitis
Benes, Z.; Koten, J.; Kabelková, M.; Benes, J.
Klinicka Mikrobiologie a Infekcni Lekarstvi 12(6): 240-243
2006
ISSN/ISBN: 1211-264X PMID: 17290547 Document Number: 602010
Expanding travel industry may increase the incidence of some rare infections diseases. One of them is cryptococcosis developing especially in immunosuppressed individuals. However, massive cryptococcal infection may lead to a severe clinical course even in people without impaired immunity. The case report describes the disease in a non-immunosuppressed 26-year-old man who returned to the Czech Republic after a 2.5-month stay in Egypt. He was hospitalized for increasing fever, weight loss and changes in behaviour. Thorough examination including thoracoscopy and histological analysis of the mediastinal lymph nodes revealed cryptococcal disease. Various organs, mainly the small bile ducts, were affected by the dissemination mimicking primary sclerosing cholangitis. The discussion is concerned with the properties of the Cryptococcus, variety of clinical manifestations, differential diagnosis and treatment.