Open AccessConcurrent central nervous system infective pathology in a severely immunocompromised patient
Author(s) -
Thein Swe,
Bordes P Laurent,
Nickul N Shah
Publication year - 2016
Publication title -
journal of family medicine and primary care
Language(s) - English
Resource type - Journals
eISSN - 2278-7135
pISSN - 2249-4863
DOI - 10.4103/2249-4863.197304
Subject(s) - medicine , neurosyphilis , fluconazole , flucytosine , amphotericin b , cerebrospinal fluid , meningitis , cryptococcosis , immunology , central nervous system , pediatrics , pathology , human immunodeficiency virus (hiv) , dermatology , syphilis , antifungal
To our knowledge and literature search, concurrent cryptococcal meningitis and neurosyphilis in a patient have rarely been reported. Here, we report a 37-year-old male with HIV infection presented with headache and dizziness for 5 days along with memory difficulty and personality changes for about 1 week. During the hospital stay, cryptococcal meningitis was confirmed with positive cerebral spinal fluid (CSF) cryptococcal antigen titer (1:320) and positive CSF culture. Diagnosis of neurosyphilis was made based upon CSF white blood cell count of 85 cells/μL, with CSF total protein of 87 mg/dL, reactive CSF treponemal antibody, and fluorescent treponemal antibody. The patient was treated with amphotericin B, flucytosine, fluconazole, and benzathine penicillin G, and the patient was recovered and discharged. HIV patients are at high risk of developing severe infections of the central nervous system. Awareness should be made not only to single infection but also for dual pathology for a better and life-saving management.