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A Case of Human Immunodeficiency Virus Infection Presenting as Cryptococcal Meningitis not Accompanied by Pleocytosis
Hye Kyung Bae/Hyun Min Cha/Yoon Ho Ko/Pum Joon Kim/Chang Wook Kim/Sung Kwang Yong/Dong Gun Lee/Seong Heon Wie/Sang Il Kim/Jung Hyun Choi/Yang Ree Kim/Wan Shik Shin
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Vol.31 Num.5 (p455~459)
In Korea, cryptococcal meaningitis is a rare opportunistic infection in patients with human immunodeficiency virus (HIV) infection. Cryptococcal meningitis in non-HIV infected patients is usually accompanied by cerebrospinal fluid (CSF) pleocytosis, but sometimes this is not the case in HIV-infected patients. As the number of patients with HIV infection increases in Korea, such atypical cryptococcal meningitis should be considered as a cause of fever of undetermined origin. In addition, if such a diagnosis is made, underlying AIDS should be ruled out.
A 61-year old man was admitted to the hospital because of hematemesis. During
hospitalization, he experienced fever and a mild continuous headache. Physical examination showed no neck stiffness. For the evaluation of persistent fever, CSF examination was performed, which showed elevated protein, decreased sugar, normal pressure, and no pleocytosis. Meningitis due to Cryptococcus neoformans was diagnosed by positive CSF india ink preparation and fungus culture. HIV infection was later confirmed by Western blot analysis.



Keywords : Cryptococcal meningitis, Human immunodeficiency virus