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CASE REPORT
Year : 2020  |  Volume : 13  |  Issue : 1  |  Page : 46-48

Cryptococcal meningitis with pulmonary cryptococcoma in an immunocompetent patient: A case report


1 Department of Medicine, Miri General Hospital, Sarawak, Malaysia
2 Infectious Disease Unit, Department of Medicine, Sarawak General Hospital, Sarawak, Malaysia

Correspondence Address:
Kee Tat Lee
Department of Medicine, Miri General Hospital, Sarawak
Malaysia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1995-7645.273574

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Rationale: Cryptococcal infections commonly occur in immunosuppressed patients and are uncommon in immunocompetent persons. Patient concerns: A 32 year old lady, active smoker presented with right chest pain, dry cough and loss of weight. Initial chest radiograph showed a lobulated lung mass in the right lower lobe. She developed headache and right cranial nerve palsy during admission. Various investigations were done including lumbar puncture, brain and chest imaging. Diagnosis: Cryptococcal meningitis with pulmonary cryptococcoma. Interventions: She received five months of effective antifungal treatment; however, the patient did not respond well. Subsequently, removal of pulmonary cryptococcoma was done. Outcomes: Her condition improved and she no longer had any headache. Lessons: Disseminated cryptococcosis is rare in immunocompetent patient. Our case highlights the importance of high index of suspicion and we postulate that lobectomy helped in reducing the cryptococcal burden in her body, thus facilitating better response to antifungal therapy.


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