Skip to main content

Advertisement

SpringerLink
Log in

Cryptococcal Meningitis: Description of 3 Cases and Estimation of T-cell Subsets

  • Original Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objectives

To describe three cases of cryptococcus neoformans meningitis and evaluate their cellular immunity.

Methods

This study involved three cases of cryptococcus neoformans meningitis admitted to Children’s Hospital of Shanxi Province between July 2010 and July 2011. Clinical presentations, laboratory findings, treatment and outcome in these cases has been discussed.

Results

Staining cerebrospinal fluid (CSF) with India ink showed Cryptococcus neoformans. Flow cytometric analysis of T-cell subsets revealed that their cellular immunity were depressed, which mainly embodies decline in CD4+ levels.

Conclusions

The authors speculate that decreased CD4+ T lymphocyte counts are attributed to cryptococcal infection, emphasizing the significance and importance of evaluating cellular immunity in patients who present with unusual infections. Early diagnosis of cryptococcal meningitis and appropriate antifungal therapy are essential to achieve a better outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Meyer W, Castañeda A, Jackson S, Huynh M, Castañeda E; IberoAmerican Cryptococcal Study Group. Molecular typing of IberoAmerican cryptococcus neoformans isolates. Emerg Infec Dis. 2003;9:189–95.

    Article  Google Scholar 

  2. Mitchell TG, Perfect JR. Cryptococcosis in the era of AIDS–100 years after the discovery of Cryptococcus neoformans. Clin Microbiol Rev. 1995;8:515–48.

    CAS  PubMed Central  PubMed  Google Scholar 

  3. Chaudhary MW, Sardana K, Kumar P, Dewan V, Anand VK. Disseminated infection with Cryptococcus neoformans var neoformans in an 8 years immunocompetent girl. Indian J Pediatr. 2005;72:85.

    Article  PubMed  Google Scholar 

  4. Speed BR, Kaldor J. Rarity of cryptococcal infection in children. Pediatr Infect Dis J. 1997;16:536–7.

    Article  CAS  PubMed  Google Scholar 

  5. Yuanjie Z, Jianghan C, Nan X, Xiaojun W, Hai W, Wanqing L, et al. Cryptococcal meningitis in immunocompetent children. Mycoses. 2012;55:168–71.

    PubMed  Google Scholar 

  6. Yuanjie Z, Jianghan C, Julin G, Hai W. Cryptococcal meningitis in an immunocompetent 8-year-old girl. Mycoses. 2009;52:377–8.

    Article  PubMed  Google Scholar 

  7. Swe Han KS, Bekker A, Greeff S, Perkins DR. Cryptococcus meningitis and skin lesions in an HIV negative child. J Clin Pathol. 2008;61:1138–9.

    Article  PubMed  Google Scholar 

  8. Shinjoh M, Miyairi I, Sakurai M, Takahashi M, Ariyasu D, Nakayama T, et al. Cryptococcal meningitis in an immunocompetent child. Eur J Pediatr. 2005;164:596–7.

    Article  PubMed  Google Scholar 

  9. Othman N, Abdullah NA, Wahab ZA. Cryptococcal meningitis in an immunocompetent child: A case report and literature review. Southeast Asian J Trop Med Public Health. 2004;35:930–4.

    PubMed  Google Scholar 

  10. Kaur R, Mittal N, Rawat D, Mathur MD. Cryptococcal meningitis in a neonate. Scand J Infect Dis. 2002;34:542–3.

    Article  PubMed  Google Scholar 

  11. Chen S, Sorrell T, Nimmo G, Speed B, Currie B, Ellis D, et al. Epidemiology and host- and variety-dependent characteristics of infection due to Cryptococcus neoformans in Australia and New Zealand. Australasian Cryptococcal Study Group. Clin Infect Dis. 2000;31:499–508.

    Article  CAS  PubMed  Google Scholar 

  12. Rozenbaum R, Gonçalves AJ. Clinical epidemiological study of 171 cases of cryptococcosis. Clin Infect Dis. 1994;18:369–80.

    Article  CAS  PubMed  Google Scholar 

  13. Lopes JO, Costa JM, Streher LA, Clock C, Pinto MS, Alves SH. Cryptococcosis not related to AIDS in Rio Grande do Sul: A report of 8 cases and a review of the literature. Rev Soc Bras Med Trop. 1997;30:369–72.

    Article  CAS  PubMed  Google Scholar 

  14. Huang KY, Huang YC, Hung IJ, Lin TY. Cryptococcosis in nonhuman immunodeficiency virus-infected children. Pediatr Neurol. 2010;42:267–70.

    Article  PubMed  Google Scholar 

  15. Severo CB, Xavier MO, Gazzoni AF, Severo LC. Cryptococcosis in children. Paediatr Respir Rev. 2009;10:166–71.

    Article  PubMed  Google Scholar 

  16. Bicanic T, Harrison TS. Cryptococcal meningitis. Brit Med Bull. 2004;72:99–118.

    Article  PubMed  Google Scholar 

  17. Salit RB, Hankey KG, Yi R, Rapoport AP, Mann DL. Detection of CD4(+) T-cell antibodies in a patient with idiopathic CD4 T lymphocytopenia and cryptococcal meningitis. Br J Haematol. 2007;139:133–7.

    Article  CAS  PubMed  Google Scholar 

  18. Cheung MC, Rachlis AR, Shumak SL. A cryptic cause of cryptococcal meningitis. CMAJ. 2003;168:451–2.

    PubMed Central  PubMed  Google Scholar 

  19. Muller J. Immunological aspects of cryptococcosis in AIDS patients. In: van den Bossche H, MacKenzie DWR, Cauwenbergh G, van Cutsem J, Drouhet E, Dupont B, eds. Mycoses in AIDS Patients. New York: Plenum; 1990. pp. 123–32.

    Chapter  Google Scholar 

  20. Murphy JW. Clearance of cryptococcus neoformans from immunologically suppressed mice. Infect Immun. 1989;57:1946–52.

    CAS  PubMed Central  PubMed  Google Scholar 

  21. Levitz SM. The ecology of cryptococcus neoformans and the epidemiology of cryptococcosis. Rev Infect Dis. 1991;13:1163–9.

    Article  CAS  PubMed  Google Scholar 

  22. Saag MS, Graybill RJ, Larsen RA, Pappas PG, Perfect JR, Powderly WG, et al. Practice guidelines for the management of cryptococcal disease. Infectious Diseases Society of America. Clin Infect Dis. 2000;30:710–8.

    Article  CAS  PubMed  Google Scholar 

  23. Perfect JR, Dismukes WE, Dromer F, Goldman DL, Graybill JR, Hamill RJ, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2010;50:291–322.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank the children for their consent and cooperation.

Conflict of Interest

None.

Role of Funding Source

None

Author information

Authors and Affiliations

  1. Department of Laboratory, Children’s Hospital of Shanxi Province, Taiyuan, 030001, China

    Lei Zhu, Rui Huang, Huimin Guo, Jinli Zhang & Chen Dong

  2. Department of Neurology, Children’s Hospital of Shanxi Province, Taiyuan, China

    Hong Han

Authors
  1. Lei Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rui Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Huimin Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jinli Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chen Dong
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hong Han
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lei Zhu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhu, L., Huang, R., Guo, H. et al. Cryptococcal Meningitis: Description of 3 Cases and Estimation of T-cell Subsets. Indian J Pediatr 81, 536–540 (2014). https://doi.org/10.1007/s12098-013-1087-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-013-1087-7

Keywords

Search

Navigation