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Reversible visual disturbance due to cryptococcal uveitis in a non-HIV individual.


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Title: Reversible visual disturbance due to cryptococcal uveitis in a non-HIV individual.
Authors: Nakamura, Shigeki / Izumikawa, Koichi / Seki, Masafumi / Fujimoto, Kyoko / Mishima, Kazuaki / Kakeya, Hiroshi / Yamamoto, Yoshihiro / Yanagihara, Katsunori / Mizuta, Yohei / Kitaoka, Takashi / Kohno, Shigeru
Issue Date: Jun-2008
Publisher: Taylor & Francis
Citation: Medical Mycology, 46(4), pp.367-370; 2008
Abstract: A 52-year-old man without underlying diseases visited a local hospital with symptoms of memory deficit and mild headache. Radiological examination of the brain with computed tomography (CT) revealed hydrocephalus. Etiology was not revealed by cerebrospinal fluid (CSF) analysis and a ventricular-atrial (V-A) shunt was installed. The patient had congestion and dacryorrhea of the right eye and uveitis was diagnosed three months after placement of the V-A shunt. The serum cryptococcal antigen (CrAg) tested positive at a titration of 64 times. Additionally, samples of the right eye anterior chamber aqueous humor (ACAH), cerebrospinal fluid (CSF) and prostate fluid were positive for Cryptococcus antigen at a titration of 128 times. In addition, Cryptococcus neoformans var. grubii was isolated from the peripheral blood, CSF and ACAH, resulting in a diagnosis of disseminated cryptococcosis. Fluconazole (FLCZ) at 800 mg/day was administered for the first two days, followed by a 400 mg/day maintenance dose. After six months of treatment, his visual power recovered. This is a rare case of disseminated cryptococcosis involving uveitis, which was successfully treated by FLCZ. Disseminated cryptococcosis should be considered in cases with mild symptoms and V-A shunt installation for hydrocephalus.
Keywords: Cryptococcal uveitis / Disseminated cryptococcosis / Fluconazole loading dose / Non-HIV individual / V-A shunt
URI: http://hdl.handle.net/10069/27086
ISSN: 13693786
DOI: 10.1080/13693780701885461
PubMed ID: 18415845
Type: Journal Article
Text Version: author
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/27086

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