PMID- 38313397
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240206
IS  - 1179-1594 (Print)
IS  - 1179-1594 (Electronic)
IS  - 1179-1594 (Linking)
VI  - 17
DP  - 2024
TI  - Concomitant of Cryptococcal Meningitis and COVID-19 in a Female Patient with 
      Primary Nephrotic Syndrome and Type 2 Diabetes.
PG  - 279-285
LID - 10.2147/RMHP.S451991 [doi]
AB  - BACKGROUND: Patients with primary nephrotic syndrome (PNS) are at an increased 
      risk of developing various infections due to the long-term use of 
      immunosuppressive agents. Cryptococcal meningitis (CM) is an uncommon but severe 
      complication that can occur in patients with PNS, particularly those receiving 
      immunosuppressive medications. CASE DESCRIPTION: This case report describes a 
      middle-aged female patient with PNS and type 2 diabetes mellitus (T2DM) who 
      developed CM. She received a combination regimen of cyclophosphamide and 
      prednisone, achieving partial remission of PNS. However, she later returned to 
      the hospital with high fever and headache. At admission, her nasopharyngeal 
      swab test was positive for severe acute respiratory 
      syndrome-coronavirus-2 (SARS-CoV-2) and she received therapy of 
      dexamethasone and favipiravir, but her fever and headache were not improved. 
      Following a lumbar puncture was performed for her and CM was diagnosed based on a 
      positive Cryptococcus culture in the cerebrospinal fluid. The patient's 
      cyclophosphamides were temporarily discontinued, and antifungal therapy with 
      amphotericin B liposome and fluconazole was initiated. Despite a noticeable 
      increase in her blood glucose levels due to infection during her hospitalization, 
      she showed improvement with intensified glycemic control treatment. The 
      anti-infection showed significant effectiveness, and the patient's proteinuria 
      remained stable during follow-up. CONCLUSION: The patient with PNS and T2DM was 
      concurrently diagnosed with both CM and coronavirus disease 2019 (COVID-19), 
      marking the first reported case of such co-infections in these patients. Prompt 
      diagnosis and appropriate antifungal therapy are crucial for improved outcomes of 
      PNS patients with CM and COVID-19.
CI  - (c) 2024 Liang and Li.
FAU - Liang, Dongrui
AU  - Liang D
AD  - 2nd Department of Ophthalmology, Baoding No.1 Central Hospital of Hebei Medical 
      University, Baoding, Hebei, People's Republic of China.
FAU - Li, Xiaodong
AU  - Li X
AUID- ORCID: 0000-0002-9231-4853
AD  - Department of Nephrology, Baoding No.1 Central Hospital of Hebei Medical 
      University, Baoding, Hebei, People's Republic of China.
LA  - eng
PT  - Case Reports
DEP - 20240131
PL  - England
TA  - Risk Manag Healthc Policy
JT  - Risk management and healthcare policy
JID - 101566264
PMC - PMC10838511
OTO - NOTNLM
OT  - COVID-19
OT  - cryptococcal meningitis
OT  - primary nephrotic syndrome
OT  - type 2 diabetes mellitus
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2024/02/05 06:42
MHDA- 2024/02/05 06:43
PMCR- 2024/01/31
CRDT- 2024/02/05 04:41
PHST- 2023/11/27 00:00 [received]
PHST- 2024/01/26 00:00 [accepted]
PHST- 2024/02/05 06:43 [medline]
PHST- 2024/02/05 06:42 [pubmed]
PHST- 2024/02/05 04:41 [entrez]
PHST- 2024/01/31 00:00 [pmc-release]
AID - 451991 [pii]
AID - 10.2147/RMHP.S451991 [doi]
PST - epublish
SO  - Risk Manag Healthc Policy. 2024 Jan 31;17:279-285. doi: 10.2147/RMHP.S451991. 
      eCollection 2024.