Title:Disseminated Cryptococcosis in Idiopathic CD4+ Lymphocytopenia
Volume: 23
Issue: 1
Author(s): Ankita Dewangan, Jitendra Singh, Dinesh Kumar, Nilesh Kumar, Kailash Kumar and Anju Dinkar*
Affiliation:
- Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh,
India
Keywords:
Cryptococcal meningitis, ICL opportunistic infections, impaired immunity, immunocompetent, rare entity, non- HIV.
Abstract:
Introduction: Idiopathic CD4+ Lymphocytopenia (ICL) is a rare entity grouped in non–
HIV-related syndromes. ICL is characterized by a marked low CD4 T cell count of <300 cells/mm3
with ambiguous natural history and prognosis. In addition, cryptococcal and nontuberculous mycobacterial
infections are reported as known opportunistic infections. Therefore, management turns around
vigilant follow-up and treatment of the current clinical scenario of these patients.
Case Presentation: Here, a 55-year-old lady was referred with a history of diffuse headache and intermittent
fever for two months, projectile vomiting, and altered mental status for five days. Nonpruritic
maculopapular rashes and diffuse desquamation of the skin were noted. She had no significant
previous medical history. Based on clinical findings and investigations, she was diagnosed with ICL
having disseminated cryptococcosis. Unfortunately, the patient did not undergo specific treatment as
she was recognized late, and unfortunately, she died.
Conclusion: It is of paramount importance to recognize the clinical entity as early as possible to start
appropriate treatment, which may positively impact the outcome. Therefore, the clinician must be
aware of disseminated cryptococcosis associated with non-HIV states.
