1. Neurological deterioration in a patient with HIV-associated cryptococcal meningitis initially improving on antifungal treatment: a case report of coincidental racemose neurocysticercosis
- Author
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Peter Chiodini, Samuel Kampondeni, Robert S. Heyderman, Thomas S. Harrison, Laura A Benjamin, David G. Lalloo, Jayne Ellis, and Newton Kalata
- Subjects
0301 basic medicine ,Antifungal ,Pediatrics ,medicine.medical_specialty ,Antifungal Agents ,medicine.drug_class ,030231 tropical medicine ,Neurocysticercosis ,qw180 ,Human immunodeficiency virus (HIV) ,wc_503 ,wl_140 ,HIV Infections ,Case Report ,Infectious and parasitic diseases ,RC109-216 ,Racemose neurocysticercosis ,Meningitis, Cryptococcal ,medicine.disease_cause ,Serology ,03 medical and health sciences ,0302 clinical medicine ,Medical microbiology ,wl_200 ,wl_100 ,medicine ,Humans ,business.industry ,HIV ,qv_252 ,Middle Aged ,Magnetic Resonance Imaging ,Multiple pathologies ,030104 developmental biology ,Infectious Diseases ,Female ,Differential diagnosis ,business ,Cryptococcal meningitis - Abstract
Background Managing HIV-associated cryptococcal meningitis (CM) can become challenging in the presence of concurrent unusual central nervous system infections. Case presentation A 58-year old HIV infected woman new ART starter, who was being treated effectively for cryptococcal meningitis, represented with worsening of neurological symptoms. Brain MRI revealed a multicystic lesion in the left temporal lobe. Anti-fungal treatment was escalated for a suspected cryptococcoma, but post-mortem CSF serological test confirmed racemose neurocysticercosis. Conclusion Patients with HIV-associated CM are highly immunocompromised and may have multiple pathologies simultaneously. In endemic countries, neurocysticercosis should be considered in the differential diagnosis where there is central nervous system deterioration despite effective therapy for CM.
- Published
- 2021