Cryptococcosis in the Bone Marrow of an HIV-Infected Patient: A Case Report
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Abstract
Cryptococcosis in the bone marrow is the rare manifestation of the disseminated cryptococcosis due to Cryptococcus neoformans. Nearly all cases occur in HIV-infected patients. This study reports a 39-year old Thai man who presents with progressive headache for a week with fever and his blood tests are found to be positive for anti-HIV antigen/antibody, anemia, leucopenia, and the CD4 count of 5/mm3. The CSF shows positive for budding encapsulated yeasts and the bone marrow biopsy shows positive cryptococcosis. The blood and CSF cultures yield C. neoformans. He is diagnosed as having the disseminated cryptococcosis in an HIV-infected patient with cryptococcal meningitis and the cryptococcosis in the bone marrow. After being treated with amphotericin B as well as frequent lumbar puncturesand followed by oral fluconazole, he clinically responds well. And then he is later treated with ARV regimen. Normochromic normocytic anemia and leucopenia in our case are presumed to be associated with the cryptococcosis in the bone marrow because they are improved after treatment of cryptococcosis only.
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