Cryptococcosis in oncology patients: a case series in a tertiary care cancer centre
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Abstract
Cryptococcosis, a relatively uncommon infection in cancer patients is often associated with delayed diagnosis and high fatality rate due to its highly heterogeneous and protean manifestations. Early recognition and initiation of appropriate antifungal therapy might have a favourable outcome in such cases. Here we report three cases of Cryptococcosis among cancer patients in a tertiary care cancer centre in South India.
All three patients were males of different ages at presentation with immunosuppression in the form of solid organ or hematologic malignancy and were using immunosuppressive medications like steroids or chemotherapeutic agents. They presented with cryptococcemia and cryptococcal meningitis. Patients with microbiologically proven cryptococcosis had poor outcome in this subgroup of patients.
1. Li L, Zhuang L, Zhou J, Shao C. Pulmonary cryptococcosis coexisting with adenocarcinoma: a case report and review of the literature. J Med Case Rep 2018; 12: 327.
2. Hu M, Chai S, Lei W, Liao K, Zhang R. Mediastinal small cell carcinoma with primary cutaneous cryptococcosis: A rare case report. Infect Drug Resist 2021; 14: 3693-3697.
3. Ettahar N, Legout L, Ajana F, Patoz P, Massongo M, Rose C, et al. Cryptococcal osteomyelitis in a patient with a lymphocytic leukemia treated with fludarabine-cyclophosphamide-rituximab. J Mycol Med 2013; 23: 57-63.
4. Sato S, Kambe E, Tamai Y. Disseminated cryptococcosis in a patient with multiple myeloma treated with daratumumab, lenalidomide, and dexamethasone. Intern Med 2019; 58: 843-847.
5. Vellayappan BA, Bharwani L. Cryptococcemia in a patient with glioblastoma: case report and literature review. Can J Neurol Sci 2012; 39: 852-854.
6. Zhang F, Li Y, Shen H, Tao J, Wang J. Case Report: Cryptococcal eosinophilic meningitis in a patient with Hodgkin lymphoma. Front Neurol 2022; 13: 898525.
7. Cunha Pereira T, Rb-Silva R, Félix Soares R, Domingues N, Mariz J. Case Report: Cryptococcal meningitis in Hodgkin’s lymphoma patient receiving brentuximab-vedotin therapy. F1000Res 2020; 9: 687.
8. Perfect JR, Dismukes WE, Dromer F, Goldman DL, Graybill JR, Hamill RJ, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of America. Clin Infect Dis 2010; 50: 291-322.
9. Mundo W, Berning A, Koullias Y, Chastain DB, Stone N, Franco-Paredes C, et al. Disseminated cryptococcal disease in a patient with chronic chylothorax and a pleurovenous catheter, a case report with autopsy findings. Open Forum Infect Dis 2021; 8: ofab258.
10. Espinel-Ingroff A, Turnidge J. The role of epidemiological cutoff values (ECVs/ECOFFs) in antifungal susceptibility testing and interpretation for uncommon yeasts and moulds. Rev Iberoam Micol 2016; 33: 63-75.
11. Pappas PG. Cryptococcal infections in non-HIV-infected patients. Trans Am Clin Climatol Assoc 2013; 124: 61-79.
12. Schmalzle SA, Buchwald UK, Gilliam BL, Riedel DJ. Cryptococcus neoformans infection in malignancy. Mycoses 2016; 59: 542-552.
13. Loyse A, Dromer F, Day J, Lortholary O, Harrison TS. Flucytosine and cryptococcosis: time to urgently address the worldwide accessibility of a 50-year-old antifungal. J Antimicrob Chemother 2013; 68: 2435-2444.
14. Robbins N, Wright GD, Cowen LE. Antifungal drugs: the current armamentarium and development of new agents. Microbiol Spectr 2016; 4: 10.1128/microbiolspec.FUNK-0002-2016.
15. Yigit N, Wu WW, Covey S, Tam W. Cryptococcosis in bone marrow following treatment for Hodgkin lymphoma. Int J Hematol 2015; 101: 211-212.
16. Vanerwegen E, Ahmadi Bidakhvidi N, Vergote VKJ, Janssens A, Deroose CM. Cerebellar hypermetabolism in a Hodgkin Lymphoma leads to diagnosis of paucisymptomatic Cryptococcus neoformans meningitis. Clin Nucl Med 2023; 48(8): e374-e376.
17. McClelland EE, Hobbs LM, Rivera J, Casadevall A, Potts WK, Smith JM, et al. The role of host gender in the pathogenesis of Cryptococcus neoformans infections. PLoS One 2013; 8(5): e63632.
2. Hu M, Chai S, Lei W, Liao K, Zhang R. Mediastinal small cell carcinoma with primary cutaneous cryptococcosis: A rare case report. Infect Drug Resist 2021; 14: 3693-3697.
3. Ettahar N, Legout L, Ajana F, Patoz P, Massongo M, Rose C, et al. Cryptococcal osteomyelitis in a patient with a lymphocytic leukemia treated with fludarabine-cyclophosphamide-rituximab. J Mycol Med 2013; 23: 57-63.
4. Sato S, Kambe E, Tamai Y. Disseminated cryptococcosis in a patient with multiple myeloma treated with daratumumab, lenalidomide, and dexamethasone. Intern Med 2019; 58: 843-847.
5. Vellayappan BA, Bharwani L. Cryptococcemia in a patient with glioblastoma: case report and literature review. Can J Neurol Sci 2012; 39: 852-854.
6. Zhang F, Li Y, Shen H, Tao J, Wang J. Case Report: Cryptococcal eosinophilic meningitis in a patient with Hodgkin lymphoma. Front Neurol 2022; 13: 898525.
7. Cunha Pereira T, Rb-Silva R, Félix Soares R, Domingues N, Mariz J. Case Report: Cryptococcal meningitis in Hodgkin’s lymphoma patient receiving brentuximab-vedotin therapy. F1000Res 2020; 9: 687.
8. Perfect JR, Dismukes WE, Dromer F, Goldman DL, Graybill JR, Hamill RJ, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of America. Clin Infect Dis 2010; 50: 291-322.
9. Mundo W, Berning A, Koullias Y, Chastain DB, Stone N, Franco-Paredes C, et al. Disseminated cryptococcal disease in a patient with chronic chylothorax and a pleurovenous catheter, a case report with autopsy findings. Open Forum Infect Dis 2021; 8: ofab258.
10. Espinel-Ingroff A, Turnidge J. The role of epidemiological cutoff values (ECVs/ECOFFs) in antifungal susceptibility testing and interpretation for uncommon yeasts and moulds. Rev Iberoam Micol 2016; 33: 63-75.
11. Pappas PG. Cryptococcal infections in non-HIV-infected patients. Trans Am Clin Climatol Assoc 2013; 124: 61-79.
12. Schmalzle SA, Buchwald UK, Gilliam BL, Riedel DJ. Cryptococcus neoformans infection in malignancy. Mycoses 2016; 59: 542-552.
13. Loyse A, Dromer F, Day J, Lortholary O, Harrison TS. Flucytosine and cryptococcosis: time to urgently address the worldwide accessibility of a 50-year-old antifungal. J Antimicrob Chemother 2013; 68: 2435-2444.
14. Robbins N, Wright GD, Cowen LE. Antifungal drugs: the current armamentarium and development of new agents. Microbiol Spectr 2016; 4: 10.1128/microbiolspec.FUNK-0002-2016.
15. Yigit N, Wu WW, Covey S, Tam W. Cryptococcosis in bone marrow following treatment for Hodgkin lymphoma. Int J Hematol 2015; 101: 211-212.
16. Vanerwegen E, Ahmadi Bidakhvidi N, Vergote VKJ, Janssens A, Deroose CM. Cerebellar hypermetabolism in a Hodgkin Lymphoma leads to diagnosis of paucisymptomatic Cryptococcus neoformans meningitis. Clin Nucl Med 2023; 48(8): e374-e376.
17. McClelland EE, Hobbs LM, Rivera J, Casadevall A, Potts WK, Smith JM, et al. The role of host gender in the pathogenesis of Cryptococcus neoformans infections. PLoS One 2013; 8(5): e63632.
| Files | ||
| Issue | Vol 15 No 6 (2023) | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/ijm.v15i6.14163 | |
| Keywords | ||
| Cryptococcosis; Immunosuppression; Hodgkin lymphoma; Adenocarcinoma; B cell lymphoma; Opportunistic pathogen | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Gangadharan S, Raveendranath S. Cryptococcosis in oncology patients: a case series in a tertiary care cancer centre. Iran J Microbiol. 2023;15(6):821-825.
