Cryptococcal Meningitis Following Cryptococcal Pneumonia in an Immunocompetent
N. Reichman, M. Elias, R. Raz, E. Flatau
Dept. of Internal Medicine B and Infectious Disease Unit, HaEmek Hospital, Afula and Rappaport Faculty of Medicine, Technion, Haifa
Cryptococcal meningitis (CM) is common in the immunocompromised (especially due to AIDS), but also occurs in immunocompetent subjects. CM can complicate cryptococcal pneumonia (CP) not only in the immunocompromised but also in the immunocompetent. We describe a healthy 26-year-old man who developed a prolonged lung infection. Diagnosis of cryptococcal pneumonia was established from bronchoscopic washings. He recovered spontaneously, so no antifungal treatment was given.
4 months later he was admitted with cryptococcal meningitis and was treated successfully with amphotericin B. An extensive immunologic study revealed no abnormalities. Since CM can complicate cryptococcal pneumonia, it is recommended that patients with CP be followed, even if recovery is apparently complete.