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Case Reports in Infectious Diseases
Volume 2016 (2016), Article ID 1725287, 4 pages
http://dx.doi.org/10.1155/2016/1725287
Case Report

Disseminated Cryptococcal Disease in Non-HIV, Nontransplant Patient

F. AlMutawa,1 D. Leto,2,3,4 and Z. Chagla2,3,4,5

1Medical Microbiology Postgraduate Training Program, Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
2Department of Medicine, McMaster University, Hamilton, ON, Canada
3Hamilton Health Sciences, Hamilton, ON, Canada
4Department of Infectious Diseases, McMaster University, Hamilton, ON, Canada
5St. Joseph Healthcare, Hamilton, ON, Canada

Received 22 July 2016; Revised 15 October 2016; Accepted 17 October 2016

Academic Editor: Pere Domingo

Copyright © 2016 F. AlMutawa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Disseminated cryptococcal infection carries a high risk of morbidity and mortality. Typical patients include HIV individuals with advanced immunosuppression or solid organ or hematopoietic transplant recipients. We report a case of disseminated cryptococcal disease in a 72-year-old male who was immunocompromised with chronic lymphocytic leukemia and ongoing chemotherapy. The patient presented with a subacute history of constitutional symptoms and headache after he received five cycles of FCR chemotherapy (fludarabine/cyclophosphamide/rituximab). Diagnosis of disseminated cryptococcal disease was made based on fungemia in peripheral blood cultures with subsequent involvement of the brain, lungs, and eyes. Treatment was started with liposomal amphotericin, flucytosine, and fluconazole as induction. He was discharged after 4 weeks of hospitalization on high dose fluconazole for consolidation for 2 months, followed by maintenance therapy.