Case Report: Cryptococcal Infection in Renal Transplant Patient

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Case Report: Cryptococcal Infection in Renal Transplant Patient

Ashwin Sidhu1*, Harrison Chu1
1California Northstate University, College of Medicine, Elk Grove, USA


Corresponding Author: Ashwin Sidhu ORCID iD and Harrison Chu ORCID iD
Address: California Northstate University, College of Medicine, Elk Grove, 9700 W Taron Drive, CA 95757, USA.
Received date: 31 May 2022; Accepted date: 17 June 2022; Published date: 27 June 2022


Citation: Sidhu A, Chu H. Case Report: Cryptococcal Infection in Renal Transplant Patient. Asp Biomed Clin Case Rep. 2022 Jun 27;5(2):68-72.


Copyright © 2022 Sidhu A, Chu H. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.


Keywords: Cryptococcal Meningitis, Renal Transplant, Case Report, Zoonotic Infection, Meningitis


Abstract


A significant portion of all invasive fungal infections in solid organ transplants are due to cryptococcus. It can be a debilitating infection and affects the quality of life in transplant patients. We report a case of a 57-year-old male patient with recent kidney transplant, who presented with cryptococcal meningitis, after exposure to birds during a trip to Mexico 1 week ago. In addition to a two-day history of generalized weakness, dizziness, intermittent fever, and lightheadedness, the patient presented with on and off headaches, increased sinus pressure, neck stiffness, clogged ear sensation, confusion, and night sweats. The patient was initially treated empirically with fluconazole. Lumber punctuation showed elevated opening pressure, increased WBC, with neutrophil predominance. Cryptococcal antigen tests were positive in both serum and cerebrospinal fluid sources. After confirmation from CSF analysis, he was administered liposomal amphotericin B and flucytosine. Patient’s symptoms rapidly improved. Due to his immunocompromised state, the patient will require lifelong fluconazole maintenance therapy. Even though kidney transplant recipients have a positive outcome in terms of longevity, they are at increased risk of post-transplant infection, such as zoonotic infections. Therefore, in any recent kidney transplant patient with meningitis symptoms, cryptococcal meningitis should always be considered. We report the appropriate criteria, procedures, and tests that allow for a cryptococcal meningitis diagnosis in immunocompromised patients.