- Cryptococcosis is defined as a potentially fatal fungal disease caused by Cryptococcus species.
- The organism is either acquired or inhaled from the environment.
- Common symptoms include fever, nausea, headache, dry cough, chest pain and double vision.
This article describes the case of a 46-year-old male patient diagnosed with renal cryptococcosis. The patient presented to the emergency with chronic diarrhoea, abdominal pain, nausea and weakness with a history of 2 weeks. His medical history revealed that he was sexually active. He also reported having lost 2 kgs of weight in 2 months.
Laboratory studies showed an increase in serum creatinine. Moreover, he was positive for an enzyme-linked immunosorbent assay for the human immunodeficiency virus with viral load of 114,121 copies per millimeter, and the CD4+ count 2 cells per cubic millimeter. The patient’s renal function continued to worsen despite fluid resuscitation. For further evaluation, doctors performed a renal biopsy. Light microscopy was remarkable of abundant yeast cells with narrow-based budding and a thick, mucinous outer capsule in the glomeruli and tubulointerstitial compartment.
Furthermore, microorganism capsules were identified in mucicarmine stain, whereas electron microscopy revealed yeast forms. The findings were consistent with the diagnosis of renal cryptococcosis. The patient suffered from neurologic and respiratory symptoms while he was hospitalised. To evaluate the cause of his symptoms, the patient’s cerebrospinal fluid was analysed which was positive for Cryptococcus neoformans.
Doctors advised treatment with liposomal amphotericin B and flucytosine. However, despite treatment, the patient died because of complications of disseminated cryptococcosis.
References
Renal Cryptococcosis https://www.nejm.org/doi/full/10.1056/NEJMicm2007464
