PMID- 31993318
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200929
IS  - 2211-7539 (Print)
IS  - 2211-7539 (Electronic)
IS  - 2211-7539 (Linking)
VI  - 27
DP  - 2020 Mar
TI  - Neurological worsening during treatment of an immunocompetent adult with 
      Cryptococcus neoformans meningitis.
PG  - 48-51
LID - 10.1016/j.mmcr.2020.01.001 [doi]
AB  - Cryptococcal meningitis is being increasingly described in immunocompetent 
      adults. We describe here a young immuncompetent adult of Indian origin from 
      Ghana, West Africa with cryptococcal meningitis who had several ups and downs 
      during his treatment. First he developed neurologic worsening due to premature 
      transition from intensive to consolidation phase therapy. Subsequently he 
      deteriorated due to "immune reconstitution inflammatory syndrome (IRIS)" like 
      phenomenon that necessitated the prolonged use of steroids. Additionally he 
      suffered serious adverse effects due to antifungal drugs including liposomal 
      amphotericin B and flucytosine. He recovered after 16 months of treatment. The 
      case highlights the possible difficulties in management of cryptococcal 
      meningitis in immunocompetent host including 'immune reconstitution like 
      syndrome'. There is need for new trial data and guidelines about treatment of 
      cryptococcosis in the non HIV host.
CI  - (c) 2020 Published by Elsevier B.V. on behalf of International Society for Human 
      and Animal Mycology.
FAU - Tanu, Singhal
AU  - Tanu S
AD  - Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, 
      400053, India.
FAU - Mihir, Munshi
AU  - Mihir M
AD  - Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, 
      400053, India.
FAU - Rajeev, Soman
AU  - Rajeev S
AD  - Jupiter Hospital, Pune, 411045, India.
FAU - Annu, Aggarwal
AU  - Annu A
AD  - Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, 
      400053, India.
LA  - eng
PT  - Case Reports
DEP - 20200116
PL  - Netherlands
TA  - Med Mycol Case Rep
JT  - Medical mycology case reports
JID - 101598259
PMC - PMC6976910
OTO - NOTNLM
OT  - Cryptococcus
OT  - Immunocompetent
OT  - Meningitis
OT  - Paradoxical upgrading reaction
COIS- None.
EDAT- 2020/01/30 06:00
MHDA- 2020/01/30 06:01
PMCR- 2020/01/16
CRDT- 2020/01/30 06:00
PHST- 2019/12/08 00:00 [received]
PHST- 2019/12/24 00:00 [revised]
PHST- 2020/01/13 00:00 [accepted]
PHST- 2020/01/30 06:00 [entrez]
PHST- 2020/01/30 06:00 [pubmed]
PHST- 2020/01/30 06:01 [medline]
PHST- 2020/01/16 00:00 [pmc-release]
AID - S2211-7539(20)30004-X [pii]
AID - 10.1016/j.mmcr.2020.01.001 [doi]
PST - epublish
SO  - Med Mycol Case Rep. 2020 Jan 16;27:48-51. doi: 10.1016/j.mmcr.2020.01.001. 
      eCollection 2020 Mar.