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Reminder of important clinical lesson
CASE REPORT
Disseminated cryptococcal infection in a patient who had kidney transplant: discrepancy between clinical symptoms and microbiological findings
  1. Suzan Dahdal1,
  2. Robert Kalicki1,
  3. Niklaus Von Steiger2,
  4. Parham Sendi2,3
  1. 1Department of Nephrology, Hypertension and Clinical Pharmacology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
  2. 2Institute of Infectious Diseases, University of Bern, Bern, Switzerland
  3. 3Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
  1. Correspondence to Dr Suzan Dahdal, suzandahdal{at}gmail.com

Summary

A 29-year-old man complained of a 2-day history of frontal headache and new-onset fever but no other symptoms. Two months prior to admission, he underwent his third kidney transplantation. Clinical and laboratory examinations were unremarkable. Brain MRI showed a meningeal irritation consistent with viral meningitis. A diagnosis of cryptococcal meningitis and fungaemia was made after detection of a remarkably high and visible load of Cryptococcus neoformans in the cerebrospinal fluid.

  • drugs and medicines
  • renal system
  • immunology
  • renal medicine
  • renal intervention

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bcr-2017-219234

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    Footnotes

    • Contributors SD: Conception of the case report, data analysis and interpretation, drafting the article, final approval of the version to be published. RK: Data analysis and interpretation, critical revision of the article, final approval of the version to be published. NVS: Data analysis and interpretation, final approval of the version to be published. PS: Data analysis and interpretation, critical revision of the article, final approval of the version to be published.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.