Case Report: Cryptococcal meningitis in Hodgkin’s Lymphoma patient receiving brentuximab-vedotin therapy [version 2; peer review: 2 approved]

Cryptococcus neoformans infections occur mostly in immunodeficient individuals, being the most common opportunistic fungal central nervous system (CNS) infection in HIV seropositive patients. Moreover, other conditions affecting host immunity, such as hematologic malignancies, organ transplantation...

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Bibliographic Details
Main Authors: Tatiana Cunha Pereira, Rita Rb-Silva, Rita Félix Soares, Nelson Domingues, José Mariz
Format: Article
Language:English
Published: F1000 Research Ltd 2020-08-01
Series:F1000Research
Online Access:https://f1000research.com/articles/9-687/v2
Description
Summary:Cryptococcus neoformans infections occur mostly in immunodeficient individuals, being the most common opportunistic fungal central nervous system (CNS) infection in HIV seropositive patients. Moreover, other conditions affecting host immunity, such as hematologic malignancies, organ transplantation and immunosuppressive drugs are implicated as risk factors. The authors present a case of a 48-year-old male with Hodgkin Lymphoma for 26 years and submitted to several lines of treatment, diagnosed with cryptococcal meningitis while on therapy with brentuximab. The patient presented with positive cerebral spinal fluid (CSF) cryptococcal antigen plus positive blood cultures. He was put under induction antifungal treatment with liposomal amphotericin B and flucytosine, as well as corticosteroid therapy with dexamethasone with headache improvement and a favorable clinical evolution. There are no reported cases of cryptococcal meningoencephalitis under CD30-directed monoclonal antibody. Furthermore, this case illustrates the risk of Cryptococcus neoformans infection in immunocompromising conditions other than HIV, underlining the need of considering this differential diagnosis when physicians face an opportunistic neuroinfection.
ISSN:2046-1402