PT  - JOURNAL ARTICLE
AU  - Gabriel Motoa
AU  - Harry Ross Powers
AU  - Lisa M Brumble
TI  - Disseminated cryptococcosis in a patient with newly diagnosed HTLV-1 infection
AID  - 10.1136/bcr-2020-235794
DP  - 2021 Jan 01
TA  - BMJ Case Reports
PG  - e235794
VI  - 14
IP  - 1
4099  - http://casereports.bmj.com/content/14/1/e235794.short
4100  - http://casereports.bmj.com/content/14/1/e235794.full
SO  - BMJ Case Reports2021 Jan 01; 14
AB  - 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.