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Ann Indian Acad Neurol. 2019 Jul-Sep;22(3):322-324. doi: 10.4103/aian.AIAN_29_18.

Cryptococcal Postinfectious Inflammatory Response Syndrome in an Immunocompetent Host.

Author information

1
Department of Neurology, Mazumdar Shaw Medical Center, Narayana Health, Bengaluru, Karnataka, India.
2
Department of Infectious Disease, Mazumdar Shaw Medical Center, Narayana Health, Bengaluru, Karnataka, India.
3
Department of Emergency Medicine, Mazumdar Shaw Medical Center, Narayana Health, Bengaluru, Karnataka, India.

Abstract

Cryptococcal-postinfectious inflammatory response syndrome (c-PIIRS) in an immunocompetent host is a rare entity. Unlike cryptococcal-immune reconstitution inflammatory syndrome, in c-PIIRS, macrophage clearance defect can be persistent, and the patient requires prolonged immunosuppressants to control inflammation. Early identification and treatment can reduce the mortality and morbidity in cryptococcal meningitis (CM). Here, we describe c-PIIRS in an apparently healthy individual who developed CM and treated with effective antifungal regimen. After initial improvement, the patient showed clinical and radiological worsening, which could be likely due to PIIRS. The patient was responded to prolonged steroids.

KEYWORDS:

Cryptococcal meningitis; immunocompetent; postinfectious inflammatory response syndrome

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