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Case report
Disseminated cryptococcosis in a patient with newly diagnosed HTLV-1 infection
  1. Gabriel Motoa1,
  2. Harry Ross Powers2 and
  3. Lisa M Brumble2
  1. 1Division Of Allery and Pulmonary Medicine, Mayo Clinic, Jacksonville, Florida, USA
  2. 2Divsion Of Infectious Diseases, Mayo Clinic, Jacksonville, Florida, USA
  1. Correspondence to Dr Lisa M Brumble; brumble.lisa{at}


Infection by human T-lymphotropic virus 1 (HTLV-1) is often seen as the cause of chronic infection or lymphoproliferative disorders, but many clinicians do not recognise its association with severe immunosuppression. We report the case of a woman in her 70s from the Caribbean who sought care at the emergency department for weakness, fatigue and weight loss. Further work-up showed atypical lymphocytosis with floral lymphocytes and smudge cells in the peripheral blood smear and hypercalcaemia. Chest CT demonstrated a moderate right pleural effusion. Results of HIV testing were negative, and screening and confirmatory tests for HTLV-1 were positive. Empiric antibiotic therapy was administered, and the patient was discharged home. Five days later, she was readmitted with shortness of breath and severe abdominal pain. A disseminated infection with Cryptococcus neoformans was diagnosed. Despite aggressive intravenous antifungal therapy, the patient died on day 7 of hospitalisation.

  • cryptococcus
  • infectious diseases

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  • Contributors GM: wrote the manuscript. HRP: wrote and edited the manuscript. LMB: edited the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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