Cryptococcal pneumonia and meningitis in a renal transplant recipient with a false negative serum cryptococcal antigen due to postzone phenomenon
Cryptococcal infection can cause significant morbidity and mortality in immunocompromised patients. We present a patient who was diagnosed with cryptococcal meningitis and pulmonary disease in the setting of a history of renal transplantation. The diagnosis was made based on growth of Cryptococcus n...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | IDCases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214250923002226 |
| _version_ | 1797435779842048000 |
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| author | Chelsea Ware Sherin Meledathu Zoon Tariq Rebecca Yee John P. Lichtenberger, III Marc O. Siegel |
| author_facet | Chelsea Ware Sherin Meledathu Zoon Tariq Rebecca Yee John P. Lichtenberger, III Marc O. Siegel |
| author_sort | Chelsea Ware |
| collection | DOAJ |
| description | Cryptococcal infection can cause significant morbidity and mortality in immunocompromised patients. We present a patient who was diagnosed with cryptococcal meningitis and pulmonary disease in the setting of a history of renal transplantation. The diagnosis was made based on growth of Cryptococcus neoformans in blood cultures and identification of cryptococcal antigen (CrAg) in cerebral spinal fluid (CSF) using a lateral flow assay (LFA). Our case is unique since the initial serum CrAg was falsely negative due to excess cryptococcal antigen preventing the formation of antigen-antibody complexes, referred to as the postzone phenomenon. This phenomenon has been reported on CSF samples but rarely reported on serum samples in patients without an HIV diagnosis. |
| first_indexed | 2024-03-09T10:52:52Z |
| format | Article |
| id | doaj.art-e678ae5e62294570bf7dbf1f30806329 |
| institution | Directory Open Access Journal |
| issn | 2214-2509 |
| language | English |
| last_indexed | 2024-03-09T10:52:52Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | IDCases |
| spelling | doaj.art-e678ae5e62294570bf7dbf1f308063292023-12-01T05:01:50ZengElsevierIDCases2214-25092023-01-0134e01898Cryptococcal pneumonia and meningitis in a renal transplant recipient with a false negative serum cryptococcal antigen due to postzone phenomenonChelsea Ware0Sherin Meledathu1Zoon Tariq2Rebecca Yee3John P. Lichtenberger, III4Marc O. Siegel5Department of Medicine, George Washington University Medical Faculty Associates, 2150 Pennsylvania Avenue, NW, Washington, DC, USA; Correspondence to: Division of Infectious Disease, George Washington University Medical Faculty Associates, 2150 Pennsylvania Avenue, NW, Suite 8-436, Washington, DC 20037, USA.Department of Medicine, George Washington University Medical Faculty Associates, 2150 Pennsylvania Avenue, NW, Washington, DC, USADepartment of Pathology, The George Washington University Hospital, 900 23rd Street, NW, Washington, DC, USADepartment of Pathology, The George Washington University Hospital, 900 23rd Street, NW, Washington, DC, USADepartment of Radiology, The George Washington University Medical Faculty Associates, 900 23rd Street NW, Washington, DC, USADepartment of Medicine, George Washington University Medical Faculty Associates, 2150 Pennsylvania Avenue, NW, Washington, DC, USACryptococcal infection can cause significant morbidity and mortality in immunocompromised patients. We present a patient who was diagnosed with cryptococcal meningitis and pulmonary disease in the setting of a history of renal transplantation. The diagnosis was made based on growth of Cryptococcus neoformans in blood cultures and identification of cryptococcal antigen (CrAg) in cerebral spinal fluid (CSF) using a lateral flow assay (LFA). Our case is unique since the initial serum CrAg was falsely negative due to excess cryptococcal antigen preventing the formation of antigen-antibody complexes, referred to as the postzone phenomenon. This phenomenon has been reported on CSF samples but rarely reported on serum samples in patients without an HIV diagnosis.http://www.sciencedirect.com/science/article/pii/S2214250923002226Cryptococcal pneumoniaCryptococcal meningitisSerum cryptococcal antigenPost-zone phenomenon |
| spellingShingle | Chelsea Ware Sherin Meledathu Zoon Tariq Rebecca Yee John P. Lichtenberger, III Marc O. Siegel Cryptococcal pneumonia and meningitis in a renal transplant recipient with a false negative serum cryptococcal antigen due to postzone phenomenon IDCases Cryptococcal pneumonia Cryptococcal meningitis Serum cryptococcal antigen Post-zone phenomenon |
| title | Cryptococcal pneumonia and meningitis in a renal transplant recipient with a false negative serum cryptococcal antigen due to postzone phenomenon |
| title_full | Cryptococcal pneumonia and meningitis in a renal transplant recipient with a false negative serum cryptococcal antigen due to postzone phenomenon |
| title_fullStr | Cryptococcal pneumonia and meningitis in a renal transplant recipient with a false negative serum cryptococcal antigen due to postzone phenomenon |
| title_full_unstemmed | Cryptococcal pneumonia and meningitis in a renal transplant recipient with a false negative serum cryptococcal antigen due to postzone phenomenon |
| title_short | Cryptococcal pneumonia and meningitis in a renal transplant recipient with a false negative serum cryptococcal antigen due to postzone phenomenon |
| title_sort | cryptococcal pneumonia and meningitis in a renal transplant recipient with a false negative serum cryptococcal antigen due to postzone phenomenon |
| topic | Cryptococcal pneumonia Cryptococcal meningitis Serum cryptococcal antigen Post-zone phenomenon |
| url | http://www.sciencedirect.com/science/article/pii/S2214250923002226 |
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