Pulmonary Cryptococcosis Co-existing with Pulmonary Tuberculosis in a Nigerian HIV-infected Patient: A Case Report
Journal Title: International Journal of TROPICAL DISEASE & Health - Year 2016, Vol 15, Issue 4
Abstract
Tuberculosis (TB) and cryptococcosis cause severe morbidity and mortality in HIV-infected individuals in sub-Saharan Africa. However, cryptococcosis and TB co-infection is rare. We present a case of pulmonary cryptococcosis co-existing with pulmonary TB in a 42 year old Nigerian woman who had received Highly Active Antiretroviral Therapy (HAART) for about 6 months with CD4 count of 98 cells/mm3. In the second month of HAART, she developed smear positive TB and was commenced on anti-TB therapy. Following initial improvement, she developed new onset cough, low grade fever, weight loss, breathlessness and chest pain. Repeat sputum Acid Fast Bacilli (AFB) was negative but GeneXpert/MTB/Rif detected Mycobacterium tuberculosis (MTB) with no resistance to Rifampicin. Sputum fungal culture and Indian ink staining confirmed cryptococcosis. The patient was commenced on oral fluconazole therapy; anti-TB and HAART were continued. She subsequently improved but was unfortunately lost to follow-up. Pulmonary cryptococcosis should be considered in the differential diagnosis of severely immunosuppressed HIV-infected patients with chronic respiratory symptoms.
Authors and Affiliations
O. F. Nwako, E. O. Ofondu, G. C. Mbata, C. O. U. Eke, A. B. Nwako, P. Obi, C. A. Nwako, M. O. Iroezindu
Keywords
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- EP ID EP328975
- DOI 10.9734/IJTDH/2016/25157
- Views 54
- Downloads 0
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