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 ORCID: 0000-0002-9685-1664, Kampondeni, Samuel, Chiodini, Peter, Harrison, Thomas, Lalloo, David G ORCID: 0000-0001-7680-2200 and Heyderman, Robert S
(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, 21 (1). 724-.

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Abstract

<h4>Background</h4>Managing HIV-associated cryptococcal meningitis (CM) can become challenging in the presence of concurrent unusual central nervous system infections.<h4>Case presentation</h4>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.<h4>Conclusion</h4>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.

Item Type: Article
Uncontrolled Keywords: HIV, Cryptococcal meningitis, Racemose neurocysticercosis
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 31 Jan 2022 12:31
Last Modified: 18 Jan 2023 21:14
DOI: 10.1186/s12879-021-06425-9
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3147886