Abstract
A case of meningitis due to Cryptococcus neoformans var. gattii coincident with disseminated Nocardia transvalensis infection is reported. Nocardia infection initially progressed despite high-dose antimicrobial therapy. Although a specific immunologic defect could not be defined, in vitro lymphocyte proliferation in response to stimulation with the Nocardia isolate was reduced. It is proposed that coinfection with Cryptococcus neoformans may have contributed to the observed impairment of lymphocyte function, leading to disseminated Nocardia disease and a suboptimal treatment response.
MeSH terms
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Anti-Bacterial Agents
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Antifungal Agents / therapeutic use
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Bacteremia / complications
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Bacteremia / diagnosis*
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Bacteremia / drug therapy
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Cryptococcosis / complications
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Cryptococcosis / diagnosis*
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Cryptococcosis / drug therapy
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Cryptococcus neoformans / isolation & purification*
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Drug Therapy, Combination / therapeutic use
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Female
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Follow-Up Studies
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Humans
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Magnetic Resonance Imaging
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Meningitis, Bacterial / complications
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Meningitis, Bacterial / diagnosis*
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Meningitis, Bacterial / drug therapy
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Microbial Sensitivity Tests
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Middle Aged
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Nocardia Infections / complications
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Nocardia Infections / diagnosis*
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Nocardia Infections / drug therapy
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Treatment Outcome
Substances
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Anti-Bacterial Agents
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Antifungal Agents