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Cryptococcus gattii Meningoencephalitis in an Immunocompetent Person 13 Months after Exposure

Georgi, A. ; Schneemann, M. ; Tintelnot, K. ; Calligaris-Maibach, R. ; Meyer, S. ; Weber, R. ; Bosshard, P.

In: Infection, 2009, vol. 37, no. 4, p. 370-373

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    Titre
    • Cryptococcus gattii Meningoencephalitis in an Immunocompetent Person 13 Months after Exposure
    Auteur
    • Georgi, A.. Dept. of Medicine, University Hospital Zurich, Zurich, Switzerland
    • Schneemann, M.. Dept. of Medicine, University Hospital Zurich, Zurich, Switzerland
    • Tintelnot, K.. Robert Koch Institute, Berlin, Germany
    • Calligaris-Maibach, R.. Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
    • Meyer, S.. Dept. of Medicine, Cantonal Hospital, Glarus, Switzerland
    • Weber, R.. Division of Infectious Diseases and Hospital Epidemiology, Department of Medicine, University Hospital Zurich, Zurich, Switzerland
    • Bosshard, P.. Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
    Type de document
    • Postprint
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:316579
    Summary
    Abstract : A 53-year old immunocompetent Swiss female is described who developed severe meningoencephalitis due to infection with Cryptococcus gattii 13 months following exposure on Vancouver Island, Canada. Diagnosis was based on cerebrospinal fluid (CSF) examination, i.e., positive India-ink staining, positive latex particle agglutination, and positive culture. Species identification was performed by growth on L-canavanine-glycine-bromthymol blue medium and by sequencing of the intergenic and internal transcribed spacer regions of the rRNA genes. After initial therapy with fluconazole by which the patient did not improve, therapy was changed to amphotericin B and flucytosine and later to high-dose fluconazole and amphotericin B. Despite long-term treatment and external drainage of the CSF, the patient's condition improved only slowly. The patient was discharged after 132 days of hospitalization