Cryptococcal meningitis presenting as sinusitis in a renal transplant recipient

Cryptococcal meningitis is a relatively common invasive fungal infection in immunocompromised patients, especially in solid organ transplant recipients. Clinical presentation typically includes fever, headache, photophobia, neck stiffness, and/or altered mental status. Unusual presentations may dela...

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Bibliographic Details
Published in:Transplant infectious disease 2013-10, Vol.15 (5), p.E187-E190
Main Authors: Iyer, S.P., Movva, K., Wiebel, M., Chandrasekar, P., Alangaden, G., Carron, M., Tranchida, P., Revankar, S.G.
Format: Article
Language:English
Subjects:
Amphotericin B
Antifungal Agents - therapeutic use
Cryptococcus
Cryptococcus neoformans - drug effects
Cryptococcus neoformans - immunology
Cryptococcus neoformans - isolation & purification
Diagnosis, Differential
Female
Fluconazole - therapeutic use
Health risk assessment
Humans
Immunocompromised Host
Kidney Transplantation - adverse effects
meningitis
Meningitis, Cryptococcal - diagnosis
Meningitis, Cryptococcal - drug therapy
Meningitis, Cryptococcal - microbiology
Middle Aged
renal transplantation
sinusitis
Sinusitis - diagnosis
Sinusitis - drug therapy
Sinusitis - microbiology
Transplants & implants
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Summary:Cryptococcal meningitis is a relatively common invasive fungal infection in immunocompromised patients, especially in solid organ transplant recipients. Clinical presentation typically includes fever, headache, photophobia, neck stiffness, and/or altered mental status. Unusual presentations may delay diagnosis. Therapy is challenging in renal transplant patients because of the nephrotoxicity associated with amphotericin B, the recommended treatment. We present a case of cryptococcal meningitis in a renal transplant recipient presenting as acute sinusitis with successful treatment using fluconazole as primary therapy.
ISSN:1398-2273
1399-3062
DOI:10.1111/tid.12128