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Int J STD AIDS. 2018 Oct;29(12):1250-1254. doi: 10.1177/0956462418773219. Epub 2018 May 11.

Fatal cryptococcal meningitis in an AIDS patient complicated with immune reconstitution syndrome refractory to prolonged amphotericin B treatment.

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1 Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, USA.
2 Department of Radiology, Yale University School of Medicine, New Haven, CT, USA.
3 Department of Pathology, Indiana University Health Pathology Laboratory, Indianapolis, IN, USA.


Cryptococcus neoformans is a ubiquitous encapsulated environmental yeast that can cause severe central nervous system disease, primarily in immune compromised hosts. In patients with AIDS, the spectrum of cryptococcal central nervous system disease includes meningitis, cystic lesions, and mass-like cryptococcomas. We report a fatal case of meningitis and cerebritis caused by C. neoformans in an AIDS patient refractory to multiple courses of liposomal amphotericin B despite immune recovery with antiretroviral therapy. This case highlights ongoing diagnostic and therapeutic challenges in the face of treatment failure for cryptococcal meningitis and reinforces the need for improved treatment approaches.


Cryptococcus neoformans; HIV; amphotericin B; meningitis

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