Neurological deterioration in a patient with HIV-associated cryptococcal meningitis initially improving on antifungal treatment: a case report of coincidental racemose neurocysticercosis

Kalata, Newton, Ellis, Jayne, Benjamin, Laura, Kampondeni, Samuel, Chiodini, Peter, Harrison, Thomas, Lalloo, David ORCID: https://orcid.org/0000-0001-7680-2200 and Heyderman, Robert (2021) 'Neurological deterioration in a patient with HIV-associated cryptococcal meningitis initially improving on antifungal treatment: a case report of coincidental racemose neurocysticercosis'. BMC Infectious Diseases, Vol 21, Issue 724.

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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 diagnos

Item Type:	Article
Subjects:	QV Pharmacology > Anti-Inflammatory Agents. Anti-Infective Agents. Antineoplastic Agents > QV 252 Antifungal agents. Antifungal antibiotics QW Microbiology and Immunology > Fungi. Pathogenic Fungi. > QW 180 Pathogenic Fungi WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections WL Nervous System > WL 100 General works WL Nervous System > WL 140 Nervous system diseases (General) WL Nervous System > WL 200 Meninges. Blood-brain barrier
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1186/s12879-021-06425-9
Depositing User:	Debbie Jenkins
Date Deposited:	24 Aug 2021 10:46
Last Modified:	24 Aug 2021 10:46
URI:	https://archive.lstmed.ac.uk/id/eprint/18738

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