Severe clinical immunodeficiency in a patient with human immunodeficiency virus infection and relatively high CD4 counts: a case report
Abstract Background The coexistence of neuromeningeal cryptococcosis and Kaposi’s sarcoma is not surprising in a patient with human immunodeficiency virus infection and a low CD4 count, although it is rarely described. However, we describe such an association in a patient with human immunodeficiency...
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| Format: | Article |
| Language: | English |
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BMC
2019-03-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s13256-019-1982-2 |
| _version_ | 1818261898719657984 |
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| author | Mickael Essouma Larry N. Tangie Mazou N. Temgoua Ulrich Gabin Kenfack Antonin N. Ndam Celestin Danwang |
| author_facet | Mickael Essouma Larry N. Tangie Mazou N. Temgoua Ulrich Gabin Kenfack Antonin N. Ndam Celestin Danwang |
| author_sort | Mickael Essouma |
| collection | DOAJ |
| description | Abstract Background The coexistence of neuromeningeal cryptococcosis and Kaposi’s sarcoma is not surprising in a patient with human immunodeficiency virus infection and a low CD4 count, although it is rarely described. However, we describe such an association in a patient with human immunodeficiency virus infection and a relatively high CD4 count. Case presentation A 41-year old Cameroonian woman presented to our hospital with subacute occipital headaches associated with photophobia, blurred vision, phonophobia, projectile vomiting, and tonic seizures. In her past history, there was an human immunodeficiency virus infection known for 12 years, for which she had been taking (with good compliance) tenofovir-lamivudine-efavirenz-based antiretroviral therapy for the same period of time. One month before the consultation, gastric Kaposi’s sarcoma had been diagnosed, justifying the treatment with doxorubicin she had received. A clinical examination was unremarkable. A computed tomography scan of her brain was normal, and cerebrospinal fluid analysis revealed Cryptococcus neoformans. Her CD4 count was 353/mm3. Orally administered antifungal treatment with fluconazole (1200 mg/day) and flucytosine (1500 mg × 4/day) was started immediately, but she died on the sixth day of this treatment. Conclusion This clinical case shows that the coexistence of neuromeningeal cryptococcosis and gastric Kaposi’s sarcoma is possible in all patients with human immunodeficiency virus infection, regardless of CD4 count. |
| first_indexed | 2024-12-12T18:54:33Z |
| format | Article |
| id | doaj.art-c84e942bfbc84c48bb5c13a2fa6193bc |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-12T18:54:33Z |
| publishDate | 2019-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-c84e942bfbc84c48bb5c13a2fa6193bc2022-12-22T00:15:17ZengBMCJournal of Medical Case Reports1752-19472019-03-011311410.1186/s13256-019-1982-2Severe clinical immunodeficiency in a patient with human immunodeficiency virus infection and relatively high CD4 counts: a case reportMickael Essouma0Larry N. Tangie1Mazou N. Temgoua2Ulrich Gabin Kenfack3Antonin N. Ndam4Celestin Danwang5Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde IDepartment of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde IDepartment of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde IDepartment of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde IDepartment of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde IDepartment of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde IAbstract Background The coexistence of neuromeningeal cryptococcosis and Kaposi’s sarcoma is not surprising in a patient with human immunodeficiency virus infection and a low CD4 count, although it is rarely described. However, we describe such an association in a patient with human immunodeficiency virus infection and a relatively high CD4 count. Case presentation A 41-year old Cameroonian woman presented to our hospital with subacute occipital headaches associated with photophobia, blurred vision, phonophobia, projectile vomiting, and tonic seizures. In her past history, there was an human immunodeficiency virus infection known for 12 years, for which she had been taking (with good compliance) tenofovir-lamivudine-efavirenz-based antiretroviral therapy for the same period of time. One month before the consultation, gastric Kaposi’s sarcoma had been diagnosed, justifying the treatment with doxorubicin she had received. A clinical examination was unremarkable. A computed tomography scan of her brain was normal, and cerebrospinal fluid analysis revealed Cryptococcus neoformans. Her CD4 count was 353/mm3. Orally administered antifungal treatment with fluconazole (1200 mg/day) and flucytosine (1500 mg × 4/day) was started immediately, but she died on the sixth day of this treatment. Conclusion This clinical case shows that the coexistence of neuromeningeal cryptococcosis and gastric Kaposi’s sarcoma is possible in all patients with human immunodeficiency virus infection, regardless of CD4 count.http://link.springer.com/article/10.1186/s13256-019-1982-2HIV infectionCD4 countImmunodeficiencyGastric Kaposi’s sarcomaNeuromeningeal cryptococcosis |
| spellingShingle | Mickael Essouma Larry N. Tangie Mazou N. Temgoua Ulrich Gabin Kenfack Antonin N. Ndam Celestin Danwang Severe clinical immunodeficiency in a patient with human immunodeficiency virus infection and relatively high CD4 counts: a case report Journal of Medical Case Reports HIV infection CD4 count Immunodeficiency Gastric Kaposi’s sarcoma Neuromeningeal cryptococcosis |
| title | Severe clinical immunodeficiency in a patient with human immunodeficiency virus infection and relatively high CD4 counts: a case report |
| title_full | Severe clinical immunodeficiency in a patient with human immunodeficiency virus infection and relatively high CD4 counts: a case report |
| title_fullStr | Severe clinical immunodeficiency in a patient with human immunodeficiency virus infection and relatively high CD4 counts: a case report |
| title_full_unstemmed | Severe clinical immunodeficiency in a patient with human immunodeficiency virus infection and relatively high CD4 counts: a case report |
| title_short | Severe clinical immunodeficiency in a patient with human immunodeficiency virus infection and relatively high CD4 counts: a case report |
| title_sort | severe clinical immunodeficiency in a patient with human immunodeficiency virus infection and relatively high cd4 counts a case report |
| topic | HIV infection CD4 count Immunodeficiency Gastric Kaposi’s sarcoma Neuromeningeal cryptococcosis |
| url | http://link.springer.com/article/10.1186/s13256-019-1982-2 |
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