Cryptococcosis

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Background

  • Can produce focal cerebral lesions or diffuse meningoencephalitis

Clinical Features

  1. Fever
  2. Headache
  3. Nausea
  4. AMS
  5. Focal neurologic deficits

Diagnosis

  • Neuroimaging usually normal
  • CSF
    • Studies
      • Crypto antigen (100% Sn & Sp)
      • Crypto culture (95%-100% Sn)
      • India Ink (60-80% Sn)
    • Opening pressure
      • Usually elevated; drain CSF until pressure is <20 or 50% of opening presure
  • Serum
    • Cryptococcal antigen testing (95% Sn)

Treatment

  • Amphotericin B 0.7mg/kg IV QD x2wk AND flucytosine 25mg/kg IV QID x2wk

Disposition

  • Admit

Source

  • Tintinalli