Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Cryptococcal meningitis is a life threatening fungal infection primarily occurring in immunocompromised patients. Here we present a case of a 64 years old lady, known diabetic and hypertensive with pure red cell aplasia on steroids and cyclosporine who initially presented with clinical features suggestive of hyponatremia. However her blood culture showed growth of Cryptococcus neoformans. Lumbar puncture showed the presence of Cryptococcal meningitis. Conventional therapy for Cryptococcal meningitis involves Liposomal Amphotericin B and Flucytosine. However, Flucytosine has been associated with bone marrow suppression and hence could not be used here due to the background of red cell aplasia. Instead we started therapy with Liposomal Amphotericin B and high dose Fluconazole. However, Fluconazole had to be stopped due to hepatotoxicity and Posaconazole was given instead but there was failure to respond to antifungal therapy with persistence of Cryptococcus in CSF India ink preparation. She developed a secondary urinary tract infection and eventually succumbed due to immune paralysis.
How to cite this article:
Arjun Talapatra, Abhisek Mukherjee, Sayan Chakraborrty, Amit Das and S. K. Todi. Cryptococcal Meningitis in a Patient with Pure Red Cell Aplasia: A Challenge Too Far.
DOI: https://doi.org/10.36478/10.59218/makrjms.2023.11.124.126
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2023.11.124.126