First report of Cryptococcus laurentii meningitis and a fatal case of Cryptococcus albidus cryptococcaemia in AIDS patients

Med Mycol. 1998 Oct;36(5):335-9.

Abstract

We report the first case of Cryptococcus laurentii meningitis and a rare case of Cryptococcus albidus cryptococcaemia in AIDS patients. Both infections were treated with amphotericin B and flucytosine. The C. laurentii meningitis was controlled after 2 weeks of treatment with no evidence of infection 20 months later. The patient with C. albidus cryptococcaemia, despite the amphotericin B/flucytosine combination therapy, died on the 14th day of treatment. The minimum inhibitory concentrations (MICs) for C. laurentii, as determined by Etest on RPMI 1640 agar, were 0.25 microg ml(-1) of amphotericin B, 1.25 microg ml(-1) flucytosine, 4 microg ml(-1) fluconazole, 0.50 microg ml(-1) itraconazole and 1.0 microg ml(-1) of ketoconazole. The MIC of amphotericin B for C. albidus was 0.5 microg ml(-1), flucytosine 1.25 microg ml(-1), fluzonazole 4 microg ml(-1), itraconazole 0.5 microg ml(-1) and ketonazole 0.25 microg ml(-1). The agreement of the amphotericin B MIC values obtained in antibiotic medium 3 by the broth microdilution method, with those obtained on casitone medium by Etest, was within a two-dilution range for both isolates. C. laurentii may cause meningitis and may also involve the lungs in AIDS patients.

Publication types

  • Case Reports

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis
  • AIDS-Related Opportunistic Infections / drug therapy
  • AIDS-Related Opportunistic Infections / microbiology*
  • Adult
  • Amphotericin B / therapeutic use*
  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use*
  • Cryptococcosis / diagnosis*
  • Cryptococcosis / drug therapy
  • Cryptococcus / classification*
  • Cryptococcus / drug effects
  • Cryptococcus / isolation & purification
  • Drug Therapy, Combination
  • Fatal Outcome
  • Female
  • Flucytosine / therapeutic use*
  • Humans
  • Male
  • Meningitis / diagnosis
  • Meningitis / drug therapy
  • Meningitis / microbiology
  • Microbial Sensitivity Tests
  • Middle Aged

Substances

  • Antifungal Agents
  • Amphotericin B
  • Flucytosine