CRYPTOCOCCAL meningitis in a HIV negative newly diagnosed diabetic patient: a CASE report.

Abstract:

BACKGROUND:This case report emphasizes the need to recognize cryptococcus as a possible cause of meningitis in non-HIV patients in Sub-Saharan Africa and to highlight the possibility of grave outcomes due to the paradoxical immune response in diabetic patients with cryptococcus meningitis. It also highlights the need for widespread availability of amphotericin-B and flucytosine in hospitals in Sub-Saharan Africa. CASE PRESENTATION:A 27 year old African lady was admitted with generalized tonic clonic seizures lasting 5 to 10 min. These seizures were preceded by severe frontal headaches radiating to the occiput and neck and associated with chills, photophobia and loss of consciousness. She was tachycardic and had tongue bites on the lateral aspects of her tongue. Kernig's and Brudzinski's signs were positive. India ink was positive on two cerebrospinal fluid (CSF) samples. She had hyperglycemia and glucosuria as well. She was diagnosed with cryptococcal meningitis in diabetes and had a remarkable response to fluconazole monotherapy. She went home on maintenance dose of fluconazole having made full recovery. and is currently on prophylactic doses of fluconazole. CONCLUSIONS:With the rising prevalence of diabetes in Sub-Saharan Africa, coupled with the low levels of adequate glucose control, cryptococcal meningitis should be considered in the differential diagnosis for diabetic patients presenting with chronic headache, fever and neurologic deficits.

journal_name

BMC Infect Dis

journal_title

BMC infectious diseases

authors

Owuor OH,Chege P

doi

10.1186/s12879-018-3625-4

subject

Has Abstract

pub_date

2019-01-03 00:00:00

pages

5

issue

1

issn

1471-2334

pii

10.1186/s12879-018-3625-4

journal_volume

19

pub_type

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