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Revista Virtual de la Sociedad Paraguaya de Medicina Interna

On-line version ISSN 2312-3893


IBANEZ FRANCO, Elvis Javier  and  DUARTE AREVALOS, Luis Enrique. Meningeal and pulmonary cryptococcosis in an immunocompetent patient. Rev. virtual Soc. Parag. Med. Int. [online]. 2022, vol.9, n.1, pp.130-135. ISSN 2312-3893.

We present the case of a 23-year-old male, with no known pathologies, a farmer, from a rural area. He presented a 1-month history of headache, nausea and vomiting, in addition to altered consciousness characterized by confusion.

The skull tomography does not show abnormalities and the lumbar puncture is compatible with meningitis, with positive Chinese ink showing Cryptococcus sp. Treatment with amphotericin B and fluconazole is started. Later, the final culture report returns: Cryptococcus gatii. Studies are carried out to rule out viral infections that return negative.

During his hospitalization, he presents nosocomial pneumonia and due to the progressive worsening of his state of consciousness and the respiratory symptoms goes to intensive care where he is hospitalized for 21 days. During his stay, the presence of C. gattii is also confirmed in bronchioalveolar lavage.

He presents multiple organ failure and death. This is the first case of cryptococcosis in an immunocompetent patient described in our center.

Keywords : cryptococcosis; cryptococcal meningitis; Cryptococcus gattii; fungal lung diseases.

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