CRYPTOCOCCOSIS: A CASE REPORT

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Abstract
This article discusses the distribution of the disease which is caused by a yeastlike organism-Cryptococcus neoformans. The case presented was a 56 year old male who had recent onset of a dull frontal headache, retro-orbital pain, and low grade fever. Three days later he was admitted to the hospital because of development of a stiff neck. He was found to have X-ray evidence of sinusitis and spinal tap revealed 303 lymphs /c mm with an occasional RBC. The original diagnosis of acute lymphocytic choriomeningitis was discarded after subsequent spinal taps revealed a decrease in spinal fluid sugar. On the 10th hospital day the spinal fluid culture for fungus revealed Cryptococcus. He was placed on Amplotericin B but continued to go downhill with vomiting, chills, fever, coma and death one month after onset of his illness. The pathological findings included multiple small pulmonary granuloma, and severe meningo-encephalitis. It is felt that he developed a terminal spread from his pulmonary lesions to the meninges. The dosage of Amphotericin B ranged from 0.5 mgs/kg to 1.5 mgs/kg and was given I.V. over a 6 hour period. Toxic effects encountered were chills, fever, vomiting and an increase in headache. The drug also caused an elevation of BUN; the cause of this elevation is unknown. The association of cryptococcus infection with other chronic diseases such as Hodgkins, tuberculosis, sarcoidosis and carcinoma is mentioned. The possibility that the granulomatus lesions in the lungs due to Cryptococcus may be misdiagnosed must be considered as the cultures are often negative and only after careful microscopic examination may one find an occasional Cryptococcus.

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