Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru
Cases of cryptococcosis have been reported in patients with COVID-19. The majority are in patients with severe symptoms or who received immunosuppressants. However, there is still no clear association between COVID-19 and cryptococcosis. We report eight cases of cerebral cryptococcosis associated wi...
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| Format: | Article |
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MDPI AG
2023-03-01
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| Series: | Tropical Medicine and Infectious Disease |
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| Online Access: | https://www.mdpi.com/2414-6366/8/3/182 |
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| author | Juana M. Huamani-Córdova Miguel Hueda-Zavaleta Victor Vargas-Bellina Lourdes Simbron-Ribbeck Katty del Rosario Chong-Chinchay Juan Carlos Gómez de la Torre Vicente A. Benítes-Zapata |
| author_facet | Juana M. Huamani-Córdova Miguel Hueda-Zavaleta Victor Vargas-Bellina Lourdes Simbron-Ribbeck Katty del Rosario Chong-Chinchay Juan Carlos Gómez de la Torre Vicente A. Benítes-Zapata |
| author_sort | Juana M. Huamani-Córdova |
| collection | DOAJ |
| description | Cases of cryptococcosis have been reported in patients with COVID-19. The majority are in patients with severe symptoms or who received immunosuppressants. However, there is still no clear association between COVID-19 and cryptococcosis. We report eight cases of cerebral cryptococcosis associated with CD4+ T lymphocytopenia in non-HIV patients after SARS-CoV-2 infection. The median age was 57 years and 5/8 were male. In addition, 2/8 of patients had diabetes, and 8/8 had a history of mild COVID-19, with a median of 75 days before diagnosis of cerebral cryptococcosis. All patients denied having received prior immunosuppressive therapy. The most frequent symptoms were confusion (8/8), headache (7/8), vomiting (6/8), and nausea (6/8) All patients were diagnosed by isolating Cryptococcus in cerebrospinal fluid. The median CD4+ and CD8+ T lymphocytes were 247 and 173.5, respectively. Other causes of immunosuppression, such as HIV or HTLV infection, were excluded in all patients. Finally, three patients died, and one presented long-term visual and auditory sequelae. The CD4+/CD8+ T lymphocyte count normalized during follow-up in those patients who survived. We hypothesize that CD4+ T lymphocytopenia in the patients in this case series could increase the risk of cryptococcosis after SARS-CoV-2 infection. |
| first_indexed | 2024-03-11T05:48:00Z |
| format | Article |
| id | doaj.art-51b9c88837684e2392b9a22f30f91c44 |
| institution | Directory Open Access Journal |
| issn | 2414-6366 |
| language | English |
| last_indexed | 2024-03-11T05:48:00Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tropical Medicine and Infectious Disease |
| spelling | doaj.art-51b9c88837684e2392b9a22f30f91c442023-11-17T14:15:34ZengMDPI AGTropical Medicine and Infectious Disease2414-63662023-03-018318210.3390/tropicalmed8030182Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, PeruJuana M. Huamani-Córdova0Miguel Hueda-Zavaleta1Victor Vargas-Bellina2Lourdes Simbron-Ribbeck3Katty del Rosario Chong-Chinchay4Juan Carlos Gómez de la Torre5Vicente A. Benítes-Zapata6Instituto Nacional de Ciencias Neurológicas, Lima 15003, PeruFacultad de Ciencias de la Salud, Universidad Privada de Tacna, Tacna 23003, PeruInstituto Nacional de Ciencias Neurológicas, Lima 15003, PeruInstituto Nacional de Ciencias Neurológicas, Lima 15003, PeruInstituto Nacional de Ciencias Neurológicas, Lima 15003, PeruRoe Clinical Laboratory, Lima 15076, PeruUnidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15024, PeruCases of cryptococcosis have been reported in patients with COVID-19. The majority are in patients with severe symptoms or who received immunosuppressants. However, there is still no clear association between COVID-19 and cryptococcosis. We report eight cases of cerebral cryptococcosis associated with CD4+ T lymphocytopenia in non-HIV patients after SARS-CoV-2 infection. The median age was 57 years and 5/8 were male. In addition, 2/8 of patients had diabetes, and 8/8 had a history of mild COVID-19, with a median of 75 days before diagnosis of cerebral cryptococcosis. All patients denied having received prior immunosuppressive therapy. The most frequent symptoms were confusion (8/8), headache (7/8), vomiting (6/8), and nausea (6/8) All patients were diagnosed by isolating Cryptococcus in cerebrospinal fluid. The median CD4+ and CD8+ T lymphocytes were 247 and 173.5, respectively. Other causes of immunosuppression, such as HIV or HTLV infection, were excluded in all patients. Finally, three patients died, and one presented long-term visual and auditory sequelae. The CD4+/CD8+ T lymphocyte count normalized during follow-up in those patients who survived. We hypothesize that CD4+ T lymphocytopenia in the patients in this case series could increase the risk of cryptococcosis after SARS-CoV-2 infection.https://www.mdpi.com/2414-6366/8/3/182COVID-19SARS-CoV-2cryptococcuscryptococcosismeningitisopportunistic infection |
| spellingShingle | Juana M. Huamani-Córdova Miguel Hueda-Zavaleta Victor Vargas-Bellina Lourdes Simbron-Ribbeck Katty del Rosario Chong-Chinchay Juan Carlos Gómez de la Torre Vicente A. Benítes-Zapata Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru Tropical Medicine and Infectious Disease COVID-19 SARS-CoV-2 cryptococcus cryptococcosis meningitis opportunistic infection |
| title | Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru |
| title_full | Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru |
| title_fullStr | Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru |
| title_full_unstemmed | Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru |
| title_short | Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru |
| title_sort | cerebral cryptococcosis associated with cd4 t lymphocytopenia in non hiv patients after sars cov 2 infection case series in a specialized institute in lima peru |
| topic | COVID-19 SARS-CoV-2 cryptococcus cryptococcosis meningitis opportunistic infection |
| url | https://www.mdpi.com/2414-6366/8/3/182 |
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