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Case Reports

Diagnostic dilemma in managing relapsing episodes of Cryptococcal meningitis in HIV infected patient; a case report

Authors:

W. S. Pannala ,

National STD/AIDS Control Programme, No 29, De Saram Place, Colombo 10, LK
About W. S.

Registrar

 

MBBS, PgD Ven

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L. P. P. Godakandaarachchi,

North Colombo Teaching Hospital, Ragama, LK
About L. P. P.

Registrar

 

MBBS, PgD Ven

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A. Wijewickrama,

National Institute of Infectious Diseases, Angoda, LK
About A.

consultant physician

 

MBBS, MD, MRCP(UK)

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J. D. Ranatunga

North Colombo Teaching Hospital, Ragama, LK
About J. D.

consultant venereologist

 

MBBS, PgD Ven, MD

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Abstract

HIV associated morbidity and mortality has dramatically been reduced over the past decade with introduction of antiretroviral therapy (ART). However, significant number of undiagnosed patients still present with advanced HIV disease. Cryptococcal meningitis, commonly caused by the fungus Cryptococcus neoformans, is one of the commonest central nervous system opportunistic infection among those who diagnosed during advanced stage of disease. Relapsing episodes of Cryptococcal meningitis is not uncommon following successful treatment. Relapses may occur due to treatment failure or development of paradoxical cryptococcal immune reconstitution inflammatory response (IRIS) following immunological recovery with ART. However, the exact cause of relapse occurring after commencement of ART is indistinguishable from treatment failures and IRIS.

 

Here, we present a case of a patient with HIV who had been treated for Cryptococcal meningitis that subsequently developed two recurrent episodes of Cryptococcal meningitis after initial Cryptococcal treatment, within consecutive two months while on ART.
How to Cite: Pannala, W.S. et al., (2016). Diagnostic dilemma in managing relapsing episodes of Cryptococcal meningitis in HIV infected patient; a case report. Sri Lanka Journal of Sexual Health and HIV Medicine. 2, pp.49–54. DOI: http://doi.org/10.4038/joshhm.v2i0.46
Published on 27 Dec 2016.
Peer Reviewed

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